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232 例中国耐药性癫痫儿童病例的手术病理组织学发现。

Surgical histopathologic findings of 232 Chinese children cases with drug-resistant seizures.

机构信息

Department of Pathology, SanBo Brain Hospital, Capital Medical University, Beijng, China.

Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijng, China.

出版信息

Brain Behav. 2020 Apr;10(4):e01565. doi: 10.1002/brb3.1565. Epub 2020 Feb 14.

Abstract

OBJECTIVES

The drug-resistant seizures are characterized by frequent and severe onset of seizures in childhood. There is only little literature had extensively explored the types of pathological brain damage in Chinese children cases. The present study aims to investigate the histopathologic findings and seizure outcomes of drug-resistant seizures in cases of 0-14-year-old children.

MATERIALS AND METHODS

About 232 children cases were retrospectively who underwent epilepsy surgery. The medical records, onset age, age of surgery, disease course, seizure type, pathological reports, and seizure outcomes of these patients were retrospectively analyzed.

RESULTS

The most common categories were malformations of cortical development (focal cortical dysplasia (FCD) was the most common type (94.36%, 67/71), found in 30.60% of the patients, tumors in 18.11%, glial scar in 12.50%, and encephalitis in 11.63%). It was found that the effective seizure outcome of FCD cases with shorter duration of epilepsy (<2 years, 87.23%) was better than that with longer duration (≥2 years, 60.00%) and the difference was statistically significant (χ  = 4.76, p < .05). Patients with FCD I, FCD II, and tumor showed the relatively better postsurgical seizure outcome than patients with other pathological types.

CONCLUSION

The malformations of cortical development (MCD) (most FCD) were the most common pathological type for children cases in China with drug-resistant seizures. It was speculated further that the FCD patients with shorter duration of epilepsy before surgery seem to have a higher ratio of being seizure-free after surgery.

摘要

目的

耐药性癫痫发作的特点是儿童时期频繁且严重的癫痫发作。目前只有少量文献广泛探讨了中国儿童耐药性癫痫病例的病理性脑损伤类型。本研究旨在探讨 0-14 岁儿童耐药性癫痫发作的组织病理学发现和癫痫发作结果。

材料和方法

回顾性分析了 232 例接受癫痫手术的儿童病例。回顾性分析了这些患者的病历、发病年龄、手术年龄、病程、癫痫发作类型、病理报告和癫痫发作结果。

结果

最常见的类别是皮质发育畸形(局灶性皮质发育不良(FCD)是最常见的类型(94.36%,67/71),占患者的 30.60%),肿瘤占 18.11%,神经胶质瘢痕占 12.50%,脑炎占 11.63%)。发现 FCD 病例中癫痫发作持续时间较短(<2 年,87.23%)的有效癫痫发作结果优于持续时间较长(≥2 年,60.00%),差异具有统计学意义(χ ²=4.76,p<0.05)。FCD I、FCD II 和肿瘤患者的术后癫痫发作结果较其他病理类型患者相对较好。

结论

皮质发育畸形(MCD)(最常见的 FCD)是中国耐药性癫痫儿童病例中最常见的病理类型。推测术前癫痫发作持续时间较短的 FCD 患者术后无癫痫发作的比例可能更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae5d/7177591/ea4183cf31a8/BRB3-10-e01565-g001.jpg

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