Liu Xiangyu, Otsuki Taisuke, Takahashi Akio, Kaido Takanobu
Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing, 210002 Jiangsu Province People's Republic of China.
Department of Neurosurgery, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551 Japan.
Springerplus. 2016 Aug 30;5(1):1434. doi: 10.1186/s40064-016-3096-2. eCollection 2016.
The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH.
The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy. At follow-up, the patient's neurodevelopmental status has been improved since the surgery.
It is generally accepted that early-onset seizures in children with SWS are associated with worse neurological and developmental outcomes. However, when surgical treatment should be considered and how it should be performed remain a longstanding controversy. We promote early surgery in children with SWS and early-onset epilepsy.
We suggest that VPH may be a useful adjuvant in the management of SWS with refractory epilepsy in early infancy and this procedure carries low neurological risk.
本文作者报告了一例罕见的3个月大患有单侧斯-韦综合征(SWS)的婴儿,该婴儿在接受矢状旁正中垂直脑半球切除术(VPH)后癫痫得到了良好控制,且既往存在的神经功能缺损未加重。据我们所知,该例患有SWS的患者是接受VPH手术年龄最小的患者。
VPH的应用成功治疗了一名在婴儿早期发病的难治性癫痫患者。随访时,患者的神经发育状况自手术以来有所改善。
一般认为,SWS患儿的早发性癫痫与更差的神经和发育结局相关。然而,何时应考虑手术治疗以及应如何进行手术仍存在长期争议。我们提倡对患有SWS和早发性癫痫的儿童进行早期手术。
我们认为VPH可能是治疗婴儿早期难治性癫痫性SWS的一种有用辅助手段,且该手术具有较低的神经风险。