Xu Xinke,Li Junliang,Chen Cheng,et al.Surgical treatment for intractable epilepsy in infants[J].Journal of Clinical Pediatric Surgery,,18():409-412.[doi:10.3969/j.issn.1671-6353.2019.05.014]
Surgical treatment for intractable epilepsy in infants
- Keywords:
- Epilepsy/SU; Treatment Outcome; Infant; Child
- CLC:
- R729;R742.1
- Abstract:
- Objective To explore the surgical outcomes of intractable epilepsy in infants.Methods Retrospective analyses were performed for 28 infants with intractable epilepsy operated between 2014 to 2016.Through chart review,clinical course,seizure type,radiography,electroencephalography,surgical procedures,seizure-free status and surgical complications were examined.Engel classification was employed for evaluating the clinical outcomes.Results Twenty-eight patients underwent different surgical procedures according to preoperative assessments.Focal leison resection (n=23),functional hemispherectomy (n=4) and vagus nerve stimulator implantation (n=1) were performed.The follow-up period was 6-24 months.According to the Engel’s classification,the outcomes were Engel Ⅰ(n=23,82.15%),Engel Ⅱ(n=2,7.14%) and Engel Ⅲ (n=1,3.57%).There were two deaths (7.14%).Conclusion Surgical treatment is effective for intractable epilepsy in infants.And thorough preoperative assesments,appropriate surgical procedures and skilled microsurgical techniques are vital for surgical success.
References:
1 Engel J Jr.Early versus late surgery for intractable seizures[J].Adv Exp Med Biol,2002,497:99-105.DOI:10.1007/978-1-4615-1335-3_11.
2 石秀玉,邹丽萍.儿童难治性癫痫临床诊断现状[J].中国实用儿科杂志[J].2011,26(7):481-483.Shi SY,Zou LP.Clinical diagnosis of refractory epilepsy in children[J].Chinese Journal of Practical Pediatrics,2011,26(7):481-483.
3 Otsuki T,Honda R,Takahashi A,et al.Surgical management of cortical dysplasia in infancy and early childhood[J].Brain Dev,2013,35(8):802-809.DOI:10.1016/j.braindev.2013.04.008.
4 Kwan P,Brodie MJ.Definition of refractory epilepsy:defining the indefinable?[J].Lancet Neurol,2010,9(1):27-29.DOI:10.1016/S1474-4422(09)70304-7.
5 蔡立新.外科手术治疗儿童难治性癫痫及临床评估[J].中国实用儿科杂志,2011,26(7):497-502.DOI:10.1007/s12583-011-0153-1.Cai LX.Surgical treatment of children with refractory epilepsy and clinical assessment[J].Chinese Journal of Practical Pediatrics,2011,26(7):497-502.DOI:10.1007/s12583-011-0153-1.
6 夏桂枝,任榕娜,杨勇辉等.婴幼儿难治性癫痫的手术治疗效果分析[J].东南国防医药,2015,17(4):378-380.DOI:10.3969/j.issn.1672-271X.2015.04.013.Xia GZ,Ren RN,Yang YH,et al.Analysis of surgical treatment of refractory epilepsy in infants[J].Military Medical Journal of Southeast China,2015,17(4):378-380.DOI:10.3969/j.issn.1672-271X.2015.04.013.
7 关宇光,栾伟,陈思畅等.岛周大脑半球离断术治疗药物难治性癫痫[J].中国微侵袭神经外科杂志,2017,22(5):209-211.DOI:10.11850/j.issn.1009-122X.2017.05.005.Guan YG,Luan W,Chen SC,et al.Peri-insular hemispherectomy for intractable epilepsy[J].Chin J Minim Invasive Neurosurg,2017,22(5):209-211.DOI:10.11850/j.issn.1009-122X.2017.05.005.
8 蒋伟,舒凯,雷霆等.婴幼儿期灾难性癫痫的术前评估[J].中华神经外科疾病研究杂志,2010,9(05):397-401.DOI:10.3969/j.issn.1671-2897.2010.05.004.Jiang W,Shu K,Lei T,et al.Preoperative assessments of patients with catastrophic infantile epilepsy[J].Chin J Neurosurg Dis Re,2010,9(05):397-401.DOI:10.3969/j.issn.1671-2897.2010.05.004.
9 Lew SM,Koop JI,Muller WM,et al.Fifty consecutive hemispherectomies:outcomes,evolution of technique,complications and lessons learned[J].Neurosurgery,2014,74(2):182-195.DOI:10.1227/NEU.0000000000000241.
10 谭启富,李龄,吴承远.癫痫外科学[M]. 第2版. 北京:人民卫生出版社,2012:584-599.Tan QF,Li L,Wu CY.Epilepsy Surgery[M].Second Edition.Beijing:People’s Medical Publishing House,2012:584-599.
11 窦万臣,郭毅,郭金竹等.半球离断术治疗半球性癫痫:疗效与并发症的早期随访[J].基础医学与临床,2017,37(5):723-725.DOI:10.3969/j.issn.1001-6325.2017.05.027.Dou WC,Guo Y,Guo JZ,et al.Hemispherotomy for hemispheric epilepsy:outcomes and early follow-ups for complications[J].Basic and Clinical Medicine,2017,37(5):723-725.DOI:10.3969/j.issn.1001-6325.2017.05.027.
Memo
收稿日期:2018-01-13。
通讯作者:李方成,Email:sjwklfc@126.com