Meyer F B, Marsh W R, Laws E R, Sharbrough F W
J Neurosurg. 1986 Mar;64(3):371-6. doi: 10.3171/jns.1986.64.3.0371.
The results of temporal lobectomy for medically refractory seizures are analyzed in 29 boys and 21 girls with a mean age of 15.8 years. The average age at onset of seizures was 7.5 years, and the time between onset and surgery averaged 8.3 years. Postoperatively, 27 patients (54%) were seizure-free, 12 patients (24%) had only occasional auras without loss of consciousness, five patients (10%) had fewer seizures, and six (12%) were unchanged. Therefore, 78% were essentially seizure-free and 88% benefited significantly from the operation. There was no significant change in the Wechsler Intelligence Scale scores before and after surgery; however, the shorter the time between seizure onset and surgery, the greater the likelihood of improvement in verbal and perceptual intelligence quotient. Social outcome was significantly improved, and a large percentage of patients were either in school or actively employed. Early consideration of temporal lobectomy in children with medically refractory seizures is recommended.
对29名男孩和21名女孩进行了颞叶切除术治疗药物难治性癫痫的结果分析,他们的平均年龄为15.8岁。癫痫发作的平均起始年龄为7.5岁,发作与手术之间的平均时间为8.3年。术后,27例患者(54%)无癫痫发作,12例患者(24%)仅有偶尔的先兆且无意识丧失,5例患者(10%)癫痫发作减少,6例患者(12%)病情无变化。因此,78%的患者基本无癫痫发作,88%的患者从手术中显著获益。手术前后韦氏智力量表评分无显著变化;然而,癫痫发作与手术之间的时间越短,言语和感知智商改善的可能性就越大。社会结局显著改善,很大比例的患者要么在上学,要么积极就业。建议对药物难治性癫痫患儿尽早考虑颞叶切除术。