CAJ | 학술논문

目的探讨小儿药物难治性癫痫的外科治疗时机及病理结果与疗效的关系.方法对71例小儿难治性癫痫进行手术治疗,术后至少随访1年,根据Engel预后分级评估手术效果.结果术后随访的难治性癫痫患儿中,无癫痫发作(Engel Ⅰ级)的45例(63％),其中全切除32例,次全切除13例,仍有癫痫发作(EngelⅡ～Ⅳ级)的26例(37％),效果与致痫灶切除程度密切相关(P＜0.05).病理结果:局灶性脑皮质发育不良31例,低级别肿瘤18例,瘢痕脑回13例,小脑回畸形6例,结节性硬化3例,其中双重病理9例.无手术死亡和永久性并发症.结论早期外科手术对小儿难治性癫痫是一种安全有效的治疗方式,其病理类型与手术结果存在一定相关性.
목적 탐토소인약물난치성전간적외과치료시궤급병리결과여료효적관계.방법 대71례소인난치성전간진행수술치료,술후지소수방1년,근거Engel예후분급평고수술효과.결과 술후수방적난치성전간환인중,무전간발작(Engel Ⅰ급)적45례(63％),기중전절제32례,차전절제13례,잉유전간발작(EngelⅡ～Ⅳ급)적26례(37％),효과여치간조절제정도밀절상관(P＜0.05).병리결과:국조성뇌피질발육불량31례,저급별종류18례,반흔뇌회13례,소뇌회기형6례,결절성경화3례,기중쌍중병리9례.무수술사망화영구성병발증.결론 조기외과수술대소인난치성전간시일충안전유효적치료방식,기병리류형여수술결과존재일정상관성.
Objective To study the pathological features and the timing and effects of epilepsy surgery in children with intractable epilepsy.Methods The outcomes of 71 pediatric cases that underwent epilepsy surgery in our department were collected.All the patients had at least 1 year of follow-up.The effects of operation were evaluated with Engel class.Results Seizure freedom (Engel Class Ⅰ outcome) was achieved in 45 cases (63％),26 patients (37％) continued to have seizures (Engel Class Ⅱ ～ Ⅳ outcome) (P ＜ 0.05).The major pathological findings in these patients included:focal cortical dysplasia in 31 cases,low grade neoplasm in 18,ulegyria in 13,polymicrogyia malformation in 6,tuberous sclerosis in 3,and dual pathology in 9.There was no death or permanent disability.Conclusions Early surgical intervention was safe and effective for the treatment of intractable epilepsy in children.The relation between the pathological features and surgical effects should be paid attention for further study.