CAJ | 학술논문

目的：对2例4月龄症状性West综合征实施大脑半球切除术后随访，并结合文献分析大脑半球切除术后癫痫控制效果及神经功能恢复状况。方法2例4月龄患儿均为一侧半球广泛病变，具有典型West综合征临床特点，进行相关检查及详细术前评估后，在导航系统引导下行功能性大脑半球切除术。结果手术过程顺利，术后2例患者发作消失。术后分别随访31个月、28个月，无癫痫发作，2例肢体运动改善，智力及认知功能明显改善，复查脑电图提示背景明显改善。均未见高幅失律。结论结合文献复习，提示对于半球病变导致的West综合征早期行手术治疗可获得满意的效果。术后不仅癫痫发作可以完全消失，而且患儿的运动、智力和认知功能在不同程度上都有所提高，生活质量明显改善。
목적：대2례4월령증상성West종합정실시대뇌반구절제술후수방，병결합문헌분석대뇌반구절제술후전간공제효과급신경공능회복상황。방법2례4월령환인균위일측반구엄범병변，구유전형West종합정림상특점，진행상관검사급상세술전평고후，재도항계통인도하행공능성대뇌반구절제술。결과수술과정순리，술후2례환자발작소실。술후분별수방31개월、28개월，무전간발작，2례지체운동개선，지력급인지공능명현개선，복사뇌전도제시배경명현개선。균미견고폭실률。결론결합문헌복습，제시대우반구병변도치적West종합정조기행수술치료가획득만의적효과。술후불부전간발작가이완전소실，이차환인적운동、지력화인지공능재불동정도상도유소제고，생활질량명현개선。
Objective To report 2 cases of symptomatic West syndrome , both of which were 4-month-old and performed hemispherectomy , and to analyze the postoperative seizure control and neurologic function of hemispherectomy combined with literature .Methods Two cases of four-month-old infants with extensive lesions involving unilateral hemisphere , were diagnosed as West syndrome .After detailed preoperative evaluation , both patients were performed functional hemispherectomy under the guidance of the neuronavigation system .Results The surgery went smoothly .The following-up was 31 months and 28 months , respectively , both of the two patients were seizure free .The motor function of the two patients were improved , and one of the patients were mild hemiparesis.The intellectual and cognitive function of both patients were improved significantly .And the background of postoperative electroencephalography ( EEG ) were improved without hypsarrhythmia .Conclusions For infantile patients with West syndrome sencondary to extensive hemispheric lesions , heimspherectomy treatment at early age are effective . After the sucessful surgery , patients could be seizure free , and the motor function , intelligence and cognitive function would be improved , and qulity of life improve significantly .