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挪威儿童和青少年部分性癫痫的外科治疗

Surgical treatment for partial epilepsy among Norwegian children and adolescents.

作者信息

Guldvog B, Løyning Y, Hauglie-Hanssen E, Flood S, Bjørnaes H

机构信息

Foundation for Health Services Research, Nordbyhagen, Norway.

出版信息

Epilepsia. 1994 May-Jun;35(3):554-65. doi: 10.1111/j.1528-1157.1994.tb02475.x.

Abstract

We conducted a retrospective longitudinal self-controlled study of 64 patients aged 4-19 years treated with resective surgery for partial epilepsy from 1952 to 1988. Approximately 60% of patients experienced > 95% reduction in seizure frequency, and 70% had worthwhile improvement of at least 75% reduction. Seizure relief was more frequent among patients who underwent operation after 1978, and significant differences by time period of operation were noted for those with temporal lobe excisions and patients with normal tissue histology. The region of resection and the age at treatment did not provide significant information with respect to seizure outcome. Postresection electrocorticography (ECoG) and EEG of the first postoperative year predicted later seizure outcome. Small neurologic deficits were more common among patients resected in the temporal lobe than in patients resected in the frontal lobe. Half of the patients with preoperative unilateral focal activity and a third of those with bilateral focal activity had normal EEG postoperatively. One fourth had discontinued antiepileptic drug (AED) therapy. As expected, long-term mortality was significantly higher than the mortality of the general population. Seven patients died during follow-up. Two male patients committed suicide.

摘要

我们对1952年至1988年期间接受部分性癫痫切除手术治疗的64例4至19岁患者进行了一项回顾性纵向自我对照研究。约60%的患者癫痫发作频率降低>95%,70%的患者有至少75%降低的显著改善。1978年后接受手术的患者癫痫发作缓解更为频繁,颞叶切除术患者和组织学正常的患者在手术时间上存在显著差异。切除区域和治疗年龄与癫痫发作结果无关。术后第一年的切除后皮质脑电图(ECoG)和脑电图可预测后期癫痫发作结果。颞叶切除患者比额叶切除患者出现小神经功能缺损更为常见。术前单侧局灶性活动的患者中有一半以及双侧局灶性活动的患者中有三分之一术后脑电图正常。四分之一的患者停止了抗癫痫药物(AED)治疗。正如预期的那样,长期死亡率显著高于一般人群。7例患者在随访期间死亡。2例男性患者自杀。

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