Fish D R, Smith S J, Quesney L F, Andermann F, Rasmussen T
Montreal Neurological Hospital, McGill University, Quebec, Canada.
Epilepsia. 1993 Mar-Apr;34(2):244-7. doi: 10.1111/j.1528-1157.1993.tb02405.x.
Etiologic, pathologic, and clinical features of possible prognostic significance were studied in 118 children who underwent frontal or temporal lobe epilepsy surgery at the Montreal Neurological Institute (MNI) between 1940 and 1980 (excluding tumor cases). Mean age of seizure onset was 5.1 years (range 0-12 years), mean age at operation was 11.7 years (range 0.6-15 years), and median duration of follow-up was 15 years (range 2-31 years). Thirteen of 45 frontal surgery patients and 43 of 73 temporal surgery patients had an excellent outcome. In the frontal surgery group, this was restricted almost entirely to patients with an established etiology, particularly if this included a circumscribed resectable structural abnormality. In the temporal surgery group, a history of early, prolonged febrile seizures was usually associated with good outcome, unless there was additional evidence of extratemporal epilepsy. In the entire series, the presence of a nonresectable structural lesion or secondarily generalized seizures was associated with a poor outcome.
对1940年至1980年间在蒙特利尔神经病学研究所（MNI）接受额叶或颞叶癫痫手术的118名儿童（不包括肿瘤病例），研究了可能具有预后意义的病因、病理和临床特征。癫痫发作的平均起始年龄为5.1岁（范围0至12岁），手术时的平均年龄为11.7岁（范围0.6至15岁），随访的中位时间为15年（范围2至31年）。45名额叶手术患者中有13名，73名颞叶手术患者中有43名预后良好。在额叶手术组中，这几乎完全局限于病因明确的患者，特别是如果病因包括一个可切除的局限性结构异常。在颞叶手术组中，早期、长时间热性惊厥病史通常与良好预后相关，除非有颞叶外癫痫的其他证据。在整个系列中，存在不可切除的结构病变或继发性全身性癫痫与预后不良相关。
