Keene D L, Higgins M J, Ventureyra E C
Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Childs Nerv Syst. 1997 Oct;13(10):530-5. doi: 10.1007/s003810050132.
A retrospective analysis of seizure outcome and quality of life assessment was done in 64 patients under 18 years of age with medically refractory epilepsy who underwent 64 primary and 16 repeat operative procedures in an attempt to control their epilepsy. At least 2 years' follow-up data were available for each patient. Operative procedures were 44 temporal lobe resections; 16 extratemporal resections; and 4 hemispherectomies. Effective control of previously intractable seizures was obtained in most patients: 55%, 11%, and 17% achieved Engel class I, II, and III status, respectively. Successful seizure control was thus obtained in 83%, while 17% (Engel class IV) failed to improve significantly after operation. Quality-of-life measures parallelled the improvements in seizures control, being highest in Engel I, outcome group and lowest in Engel IV outcome group. In appropriately selected pediatric and adolescent patients with medical refractory epilepsy, surgical management can offer a safe and effective adjunct to medication.
对64例18岁以下药物难治性癫痫患者进行了癫痫发作结果和生活质量评估的回顾性分析，这些患者接受了64次初次手术和16次重复手术，试图控制其癫痫发作。每位患者至少有2年的随访数据。手术方式包括44例颞叶切除术；16例颞叶外切除术；以及4例大脑半球切除术。大多数患者的先前难治性癫痫发作得到了有效控制：分别有55%、11%和17%的患者达到恩格尔I级、II级和III级状态。因此，83%的患者癫痫发作得到成功控制，而17%（恩格尔IV级）患者术后未显著改善。生活质量指标与癫痫发作控制的改善情况平行，在恩格尔I级结果组中最高，在恩格尔IV级结果组中最低。对于经过适当选择的药物难治性癫痫的儿童和青少年患者，手术治疗可作为药物治疗的一种安全有效的辅助手段。
