Outcome and life prospects after surgical management of medically intractable epilepsy in patients under 18 years of age
Outcome and life prospects after surgical management of medically intractable epilepsy in patients under 18 years of age
复制标题
DOI：
10.1007/s003810050132
复制
发表时间：
1997-10-01
影响因子：
1.4
通讯作者：
Ventureyra, ECG
中科院分区：
文献类型：
--
作者：
Keene, DL;Higgins, MJ;Ventureyra, ECG
对64例18岁以下难治性癫痫患者的癫痫发作结局和生活质量评估进行了回顾性分析，这些患者接受了64次原发性手术和16次重复手术，试图控制癫痫。每例患者至少有2年的随访数据。手术方式包括颞叶切除44例，颞外切除16例，大脑半球切除4例。大多数患者既往顽固性癫痫发作得到有效控制：分别有55%、11%和17%达到Engel I、II和III级状态。因此，83%的患者癫痫发作得到成功控制，而17%（Engel IV级）的患者术后未能明显改善。生活质量指标与癫痫控制的改善平行，Engel I结局组最高，Engel IV结局组最低。对于适当选择的患有药物难治性癫痫的儿童和青少年患者，手术治疗可以提供安全有效的药物辅助治疗。
A retrospective analysis of seizure outcome and quality of life assessment was done in 64 patients under 18 years of age with medically refractory epilepsy who underwent 64 primary and 16 repeat operative procedures in an attempt to control their epilepsy. At least 2 years' follow-up data were available for each patient. Operative procedures were 44 temporal lobe resections; 16 extratemporal resections; and 4 hemispherectomies. Effective control of previously intractable seizures was obtained in most patients: 55%, 11%, and 17% achieved Engel class I, II, and III status, respectively. Successful seizure control was thus obtained in 83%, while 17% (Engel class IV) failed to improve significantly after operation. Quality-of-life measures parallelled the improvements in seizures control, being highest in Engel I, outcome group and lowest in Engel IV outcome group. In appropriately selected pediatric and adolescent patients with medical refractory epilepsy, surgical management can offer a safe and effective adjunct to medication.