儿童颞叶癫痫的手术效果

Q4 Medicine

中华神经外科杂志 Pub Date : 2019-08-28 DOI:10.3760/CMA.J.ISSN.1001-2346.2019.08.011

Guangbiao Qin, K. Ma, Linhua Yi, Bojing Tan, Qian Chen, Shuhua Chen, Yanfei Luan

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引用次数: 0

摘要

目的探讨儿童颞叶癫痫的手术治疗及预后。方法对2016年9月至2018年6月首都儿科研究所附属儿童医院神经外科收治的21例颞叶癫痫患儿进行回顾性分析。根据患儿的符号学、影像学及神经电生理表现制定个体化手术治疗方案。标准颞叶前叶切除术13例，扩大颞叶病变切除3例，选择性海马杏仁核切除2例，单纯内侧颞叶病变切除1例，血管畸形切除1例，颞叶前叶切除加额叶结节切除1例。所有患者术后均进行临床随访。随访包括颅脑MRI、脑电图和Engle评分。结果21例患者均手术成功。术后未发生严重并发症。病理结果为混合性神经胶质瘤14例，多形性黄色星形细胞瘤1例，海马硬化3例，局灶性皮质发育不良IIb 1例，结节性硬化1例，脑动静脉畸形1例。21例患者随访时间为18.0±5.9个月(9 ~ 30个月)。复查头部MRI显示所有肿瘤均被完全切除，肿瘤患者未见复发。回顾脑电图，1例患者颞叶仍有大量癫痫性放电，其余20例患者癫痫性放电较术前明显减少或消失。18例患者随访12个月以上。截至最后一次随访，17例为EngleⅠ，1例为EngleⅣ。结论在综合评估颞叶癫痫的符号学、影像学和神经电生理的基础上进行个体化手术治疗，可获得良好的疗效。关键词:癫痫;颞叶;孩子;外科手术;治疗结果

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Surgical outcomes of temporal lobe epilepsy in children

Objective To explore the surgical treatment and outcomes of temporal lobe epilepsy in children. Methods A retrospective analysis was conducted on 21 children with temporal lobe epilepsy admitted to Department of Neurosurgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from September 2016 to June 2018. Individualized surgical treatment plan was formulated according to the semeiology, imaging and electroneurophysiological findings of the children. Standard anterior temporal lobectomy was undergone in 13 cases, enlarged resection of temporal lobe lesion in 3, selective hippocampal amygdala resection in 2, simple resection of medial temporal lobe lesion in 1, vascular malformation resection in 1, and anterior temporal lobe resection plus frontal lobe nodule resection in 1. All patients were followed up clinically after operation. The follow-up included cranial MRI, electroencephalogram and Engle rating. Results All 21 patients underwent successful operation. No serious complications occurred after surgery. The pathological results were mixed neuronal-glial tumor in 14 cases, pleomorphic xanthoastrocytoma in 1, hippocampal sclerosis in 3, focal cortical dysplasia IIb in 1, tuberous sclerosis in 1, and cerebral arteriovenous malformation in 1. The follow-up duration of 21 patients was 18.0±5.9 months (9-30 months). A review of head MRI showed that all tumors were completely resected and no recurrence was seen of the patients with tumor. A review of the EEG showed that there was still a large amount of epileptic discharges in the temporal lobe of 1 patient, and the epileptic discharges of the remaining 20 cases were significantly reduced or disappeared compared with preoperative conditions. Eighteen patients were followed up for more than 12 months. Up to the last follow-up, 17 cases were classified as Engle Ⅰ and 1 as Engle Ⅳ. Conclusion Individualized surgical procedures based on comprehensive assessment of the semeiology, imaging and electroneurophysiology of children with temporal lobe epilepsy could lead to good outcomes. Key words: Epilepsy; Temporal lobe; Child; Neurosurgical procedures; Treatment outcome

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.