CAJ | 학술논문

目的探讨结节性硬化所致婴儿痉挛症的手术适应证、方法和预后.方法回顾性分析采用外科手术治疗17例结节性硬化症伴婴儿痉挛症的经验.结果术后疗效按Engel分级,Ⅰ级11例,Ⅱ级4例,Ⅲ级2例.术前评估为单致痫灶的2例患者均为Ⅰ级.局限在一侧大脑半球的8例多灶性癫痫患者中,6例Ⅰ级,2例Ⅱ级.双侧大脑半球均有致痫灶但以一侧为主的7例患者中,3例Ⅰ级,2例Ⅱ级,2例Ⅲ级.平均智商(IQ)从术前的52.6分提高到61.8分.结论结节性硬化所致婴儿痉挛症具有良好的外科预后,对部分药物难治性患者在评估确定责任结节后可以考虑进行外科干预.
목적 탐토결절성경화소치영인경련증적수술괄응증、방법화예후.방법 회고성분석채용외과수술치료17례결절성경화증반영인경련증적경험.결과 술후료효안Engel분급,Ⅰ급11례,Ⅱ급4례,Ⅲ급2례.술전평고위단치간조적2례환자균위Ⅰ급.국한재일측대뇌반구적8례다조성전간환자중,6례Ⅰ급,2례Ⅱ급.쌍측대뇌반구균유치간조단이일측위주적7례환자중,3례Ⅰ급,2례Ⅱ급,2례Ⅲ급.평균지상(IQ)종술전적52.6분제고도61.8분.결론 결절성경화소치영인경련증구유량호적외과예후,대부분약물난치성환자재평고학정책임결절후가이고필진행외과간예.
Objective To investigate the surgical indications, methods and outcomes of infantile spasms with tuberous sclerosis(TS). Method Surgical treatment of 17 infantile spasms patients with TS was reviewed. Single epileptogenic tuber or lobe was resected when a focal epileptic discharge was indicated according to preoperative evaluation and EcoG, and multiple lobes or tubers resection were chosen to deal with hemisphere limited multiple epileptic foci. Anterior corpus callosotomy was added when contralateral hemisphere showed epileptic discharges. Results Acording to follow - up of 3 years in average after surgery, 11 patients had an Engel Class Ⅰ outcome, 4 patients had rare seizure ( Engel Class Ⅱ ), and 2 patients had a reduction in seizure frequency (Engel Class Ⅲ ). The mean IQ of patients was improved from 52.6 to 61. 8. Conclusions Epilepsy surgery in tuberous sclerosis with infantile spasms showes a favourable outcome,and surgical intervention should be considered in some intractable infantile spasms after corresponding tuber is derermined.