[后象限皮质发育不良所致小儿难治性癫痫的手术治疗]
[Surgery for pediatric intractable epilepsy due to posterior quadrantic cortical dysplasia].
作者信息
Liu Qing-Zhu, Cai Li-Xin, Liu Xiao-Yan, Jiang Yu-Wu, Wang Shuang, Ji Tao-Yun, Wang Wen, Cheng Wei-Ke, Wang Ruo-Fan
机构信息
Pediatric Epilepsy Center, Peking University First Hospital, Beijing 100034, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Mar;19(3):259-263. doi: 10.7499/j.issn.1008-8830.2017.03.001.
OBJECTIVE
To investigate the clinical features and surgical strategy for pediatric intractable epilepsy due to posterior quadrantic cortical dysplasia and to assess the surgical outcomes.
METHODS
The clinical features and preoperative evaluation results of 14 children with intractable epilepsy due to posterior quadrantic cortical dysplasia were retrospectively analyzed. The localization values of video-electroencephalography and intraoperative monitoring and the indications, advantages and disadvantages of temporoparietooccipital disconnection were evaluated.
RESULTS
The 14 children had different seizure types, of which spasm was the most common one. The lesions of cortical dysplasia involved the central cerebral region in 2 cases. After temporoparietooccipital disconnection in 14 patients, 13 cases were seizure-free; only one case still had seizures, but the frequency dropped by more than 50%.
CONCLUSIONS
Temporoparietooccipital disconnection is a safe and effective surgical procedure for children with intractable epilepsy due to posterior quadrantic cortical dysplasia.
目的
探讨儿童后象限皮质发育不良所致顽固性癫痫的临床特征及手术策略，并评估手术效果。
方法
回顾性分析14例后象限皮质发育不良所致顽固性癫痫患儿的临床特征及术前评估结果。评估视频脑电图和术中监测的定位价值以及颞顶枕离断术的适应证、优缺点。
结果
14例患儿发作类型各异，其中痉挛最为常见。2例皮质发育不良病变累及大脑中央区。14例患者行颞顶枕离断术后，13例无癫痫发作；仅1例仍有发作，但发作频率下降超过50%。
结论
颞顶枕离断术是治疗儿童后象限皮质发育不良所致顽固性癫痫的一种安全有效的手术方法。
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