Ko Ara, Lee Joon Soo
Division of Pediatric Neurology, Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University College of Medicine, Yangsan, Korea.
Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Clin Exp Pediatr. 2020 May;63(5):171-177. doi: 10.3345/kjp.2019.01151. Epub 2019 Nov 13.
Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are responsible for drug-resistant chronic focal epilepsy, and are the second-most common reason for epilepsy surgery in children. LEATs are extremely responsive to surgical treatment, and therefore epilepsy surgery should be considered as a treatment option for LEATs. However, the optimal time for surgery remains controversial, and surgeries are often delayed. In this review, we reviewed published article on the factors associated with seizure and cognitive outcomes after epilepsy surgery for LEATs in children to help clinicians in their decision whether to pursue epilepsy surgery for LEATs. The achievement of gross total resection may be the most important prognostic factor for seizure freedom. A shorter duration of epilepsy, a younger age at surgery, and extended resection of temporal lobe tumors have also been suggested as favorable prognostic factors in terms of seizure control. Poor cognitive function in children with LEATs is associated with a longer duration of epilepsy and a younger age at seizure onset.
低级别癫痫相关神经上皮肿瘤(LEATs)是药物难治性慢性局灶性癫痫的病因,也是儿童癫痫手术的第二大常见原因。LEATs对手术治疗极为敏感,因此癫痫手术应被视为LEATs的一种治疗选择。然而,最佳手术时间仍存在争议,手术往往被推迟。在本综述中,我们回顾了已发表的关于儿童LEATs癫痫手术后与癫痫发作及认知结果相关因素的文章,以帮助临床医生决定是否对LEATs进行癫痫手术。实现大体全切可能是癫痫发作缓解的最重要预后因素。癫痫病程较短、手术时年龄较小以及颞叶肿瘤扩大切除也被认为是癫痫控制方面的有利预后因素。LEATs患儿认知功能差与癫痫病程较长及癫痫发作起始年龄较小有关。