CAJ | 학술논문

目的研究合并海马硬化的儿童颞叶癫痫,分析不同因素对手术预后的影响.方法回顾2010年6月至2012年6月北京天坛医院神经外科行前颞叶切除术的合并海马硬化的儿童颞叶癫痫患者的临床资料25例,术后发作情况利用Engel分级将其分为又发作组与无发作组,统计起病年龄、性别、病史长短、手术年龄、影像表现及是否局灶性皮质发育不良(FCD)Ⅲa与预后的关系.结果 7例病理证实为FCDⅢa,18例为单纯海马硬化改变;病史长短对手术预后的影响差异有统计学意义(P＜0.05),而起病年龄、性别、手术年龄、影像学、病理等对手术预后无明显影响(P＞0.05).结论合并海马硬化的儿童颞叶癫痫较早行手术治疗预后较好,而FCDⅢa对手术预后影响还需进一步研究.
목적 연구합병해마경화적인동섭협전간,분석불동인소대수술예후적영향.방법 회고2010년6월지2012년6월북경천단의원신경외과행전섭협절제술적합병해마경화적인동섭협전간환자적림상자료25례,술후발작정황이용Engel분급장기분위우발작조여무발작조,통계기병년령、성별、병사장단、수술년령、영상표현급시부국조성피질발육불량(FCD)Ⅲa여예후적관계.결과 7례병리증실위FCDⅢa,18례위단순해마경화개변;병사장단대수술예후적영향차이유통계학의의(P＜0.05),이기병년령、성별、수술년령、영상학、병리등대수술예후무명현영향(P＞0.05).결론 합병해마경화적인동섭협전간교조행수술치료예후교호,이FCDⅢa대수술예후영향환수진일보연구.
Objective To study factors impacting on the outcome of surgery in intractable temporal lobe epilepsy with hippocampal sclerosis in children.Methods Between June 2010 and June 2012,clinical data of 25 pediatric patients with temporal lobe epilepsy haboring hippocampal sclerosis were collected in neurosurgical department of Beijing Tiantan Hospital.Seizure outcome was evaluated with Engel class.The correlation among age at seizure onset,sex,seizure frequency,duration of seizure,age at operation,MRI findings,pathological features and seizure outcome were assessed.Results Seven patients were confirmed as FCD Ⅲ a by neuropathology and others were hippocampal sclerosis only.Duration of seizure is a risk factor to affect the outcome of operation (P ＜ 0.05),but other factors have minor impact on the outcome of operation(P ＞ 0.05).Conclusion Early operation of temporal lobe epilepsy with hippocampal sclerosis in children predicts a better outcome.The correlation between the pathological lesions and surgical effects should be paid more attention for further study.