儿童皮质发育不良癫痫手术后的结果。
Outcome after epilepsy surgery for cortical dysplasia in children.
作者信息
Moosa Ahsan N V, Gupta Ajay
机构信息
Section of Pediatric Epilepsy, Epilepsy Center, Department of Neurology, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk S-51, Cleveland, OH, 44195, USA,
出版信息
Childs Nerv Syst. 2014 Nov;30(11):1905-11. doi: 10.1007/s00381-014-2556-7.
BACKGROUND AND PURPOSE
Epilepsy surgery for medically refractory epilepsy secondary to cortical dysplasia in children poses special challenges. We aim to review the current available literature on the outcome after epilepsy surgery for cortical dysplasia in children and critically evaluate the prognostic predictors of outcome.
METHODS
A comprehensive review of the literature was performed focusing on the outcome after epilepsy surgery for cortical dysplasia in children. Two large recent meta-analyses that included children and adults and several pediatric series of cortical dysplasia in children were reviewed.
RESULTS AND CONCLUSIONS
The overall seizure freedom rates range from 40 to 73 %, at about 2 years after surgery; most studies report 50-55% success rate. Complete resection of the epileptogenic lesion/zone remains the most important variable predictive of postoperative seizure freedom. Features unique to cortical dysplasia that limits our ability to ensure complete resection of the epileptogenic zone are reviewed.
背景与目的
针对儿童皮质发育不良继发的药物难治性癫痫进行癫痫手术存在特殊挑战。我们旨在回顾当前关于儿童皮质发育不良癫痫手术后结局的可用文献，并严格评估结局的预后预测因素。
方法
对文献进行全面回顾，重点关注儿童皮质发育不良癫痫手术后的结局。回顾了两项近期的大型荟萃分析（包括儿童和成人）以及几个儿童皮质发育不良的儿科系列研究。
结果与结论
术后约2年时，总体无癫痫发作率在40%至73%之间；大多数研究报告成功率为50%-55%。癫痫病灶/区域的完全切除仍然是术后无癫痫发作最重要的预测变量。本文回顾了皮质发育不良所特有的、限制我们确保癫痫病灶完全切除能力的特征。
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