临床小儿外科杂志2018，Vol.17Issue(4)：269-273,5.DOI:10.3969/j.issn.1671-6353.2018.04.007
儿童颞叶癫痫的临床特点及手术疗效分析
Clinical characteristics and surgical treatment of temporal lobe epilepsy in children
摘要
Abstract
Objective To explore the clinical characteristics and surgical treatment of intractable temporal lobe epilepsy in children.Methods A retrospective review was performed for consecutive patients undergoing resection for temporal lobe epilepsy between June 2012 and September 2016.Such clinical characteristics as age,laterality,pathological findings,surgical approaches and seizure outcomes were analyzed.Results Twentyfive patients(14 boys,11 girls)with a mean age(±standard deviation)of 6.55 ±2.98 years(range:2-12 years)were included.The involved side was left(n=11)and right(n=14).Among 24 patients with partial seizures,1 case of generalized seizures was Lennox-Gastaut syndrome on scalp EEG.Resections included anterior temporal lobe and hippocampus amygdala(n=6),temporal neocortex(n=4),lesion(n=12)and surgery after stereotactic implantation of depth electrode(n=3).The major pathological findings included low-grade glioma(n=8),focal cortical dysplasia(n=5),cavernous malformations(n=2),low-grade glioma with cortical dysplasia(FCDⅢb)(n=8)and hippocampal sclerosis with cortical dysplasia(FCDⅢa)(n=2).There was no occurrence of such postoperative complications as bleeding,infection or hydrocephalus.No language or memory impairment was observed after operation.Twenty-one patients remained seizure-free(21/25),seizure frequency decreased >75%(n=3,3/12)and <75%(n=1,1/12).Different surgical approaches had no significant effect on postoperative curative efficacy(P>0.05).Better seizure control outcomes could be obtained under the guidance of electrocorticography(EcoG)monitoring(P=0.034).Conclusion Temporal lobe epilepsy in childhood is different from its adult counterpart.The most common abnormalities are low-grade tumors and focal cortical dysplasia,but not hippocampus sclerosis.Intraoperative EcoG is a useful adjunct for ensuring a complete removal of epileptogenic zone and achieving optimal seizure freedom.关键词
癫痫,颞叶/外科手术/皮层发育不良/肿瘤/儿童Key words
Epilepsy/Temporal Lobe/Surgical Procedures/Operative/focal cortical dysplasia/Neo-plasms/Child引用本文复制引用
赵瑞,周渊峰,杨皓玮,施伟,周水珍,王艺,李昊..儿童颞叶癫痫的临床特点及手术疗效分析[J].临床小儿外科杂志,2018,17(4):269-273,5.基金项目
上海申康医院发展中心联合公共项目(SHDC12014106) （SHDC12014106）
上海市重点学科建设项目(2017ZZ02022) （2017ZZ02022）
