Holmes G L
Department of Neurology, Harvard Medical School, Children's Hospital, Boston, Massachusetts 02115.
Neurology. 1993 Nov;43(11 Suppl 5):S28-37.
Epilepsy surgery is becoming an increasingly used therapy for infants and young children with severe, medically intractable seizures. As in older children and adults, the presurgical evaluations of possible candidates typically consist of a detailed history, neurologic and neuropsychologic examination, and anatomic and functional neuroimaging. The "gold standard" test, however, is the recording of ictal events using simultaneous EEG and video monitoring. While temporal lobe resection is the most commonly performed surgery in older children and adults, nontemporal lobe resections, corpus callosotomies, and hemispherectomies are more commonly performed in younger children. Antiepileptic drugs remain the mainstay of treatment of children with epilepsy. However, the clinician should consider surgery early in the course of the catastrophic seizure disorders of childhood: infantile spasms, Sturge-Weber syndrome, and Rasmussen's encephalitis.
癫痫手术正越来越多地用于患有严重药物难治性癫痫发作的婴幼儿。与大龄儿童和成人一样，对可能的手术候选者的术前评估通常包括详细的病史、神经学和神经心理学检查，以及解剖学和功能性神经影像学检查。然而，“金标准”测试是使用同步脑电图和视频监测记录发作期事件。虽然颞叶切除术是大龄儿童和成人中最常进行的手术，但非颞叶切除术、胼胝体切开术和大脑半球切除术在年幼儿童中更常进行。抗癫痫药物仍然是儿童癫痫治疗的主要手段。然而，临床医生应在儿童灾难性癫痫疾病（婴儿痉挛症、斯特奇-韦伯综合征和拉斯穆森脑炎）的病程早期就考虑手术。
