'With the benefit of hindsight': Would you opt again for epilepsy surgery performed in childhood?
'With the benefit of hindsight': Would you opt again for epilepsy surgery performed in childhood?
复制标题
DOI：
10.1016/j.ejpn.2013.02.004
复制
发表时间：
2013-09-01
影响因子：
3.1
通讯作者：
van Nieuwenhuizen, Onno
中科院分区：
文献类型：
--
作者：
Engelhart, Marsha C. J. M.;van Schooneveld, Monique M. J.;van Nieuwenhuizen, Onno
工作背景：青少年和他们的照顾者如何回顾在生命早期进行的癫痫手术，以及癫痫相关的限制是否在手术后的几年仍然有效，还不充分know.Aims：为了获得回顾性评估的决定癫痫手术在早期的年龄，并清点当前癫痫相关的限制。方法：在1992年至2009年期间接受癫痫手术的177名儿童中，有129名可以接近。他们和他们的父母收到了一份评级清单，盘点是否，回顾过去，他们会再次选择癫痫手术，这是他们的答案的动机，如何成功，他们觉得手术已经和，如果有的话，癫痫相关的限制仍然生效。大多数父母也会重新选择手术。手术时年龄、术后间隔时间、手术类型与再次选择手术在统计学上显著相关。癫痫发作的自由是最重要的动机，无癫痫的受访者，目前癫痫发作的受访者大多数提到改善癫痫发作和/或药物治疗。对于目前癫痫发作儿童的父母来说，更好的发展前景是另一个重要的动机。罕见的犹豫/拒绝与权衡利弊时的不确定性有关。目前的癫痫发作没有理由认为手术失败。在儿童谁是免费的癫痫发作和抗癫痫药物，42%的生活与restrictions.Conclusions：癫痫手术，不导致癫痫发作的自由，但被认为是有益的。适当的建议应防止毫无意义的限制继续下去。(C)2013年欧洲儿科神经病学学会。由爱思唯尔有限公司出版。保留所有权利。
Background: How adolescents and their caregivers look back on epilepsy surgery performed in early life, and whether epilepsy-related restrictions are still in force years after the operation, are insufficiently known.Aims: To obtain retrospective evaluations of the decision for epilepsy surgery at an early age, and to inventory current epilepsy-related restrictions.Methods: Of 177 children who underwent epilepsy surgery between 1992 and 2009, 129 could be approached. They and their parents received a rating list inventorying whether, in retrospect, they would opt again for epilepsy surgery, which were motives for their answer, how successful they felt surgery had been and which, if any, epilepsy-related restrictions were still in force.Results: Forty-one of 44 seizure-free adolescents and 9 of 10 adolescents with current seizures were inclined to (re-)opt for surgery. Parents also would in majority re-opt for surgery. Age at surgery, post-surgical interval, nor type of surgery was statistically significantly related with re-opting for surgery. Seizure-freedom was the paramount motive of seizure-free respondents; respondents with current seizures in majority mentioned amelioration of seizures and/or medication. For parents of children with current seizures, a better developmental perspective was another important motive. Rare hesitation/refusal was related to uncertainties in weighing advantages and disadvantages. Current seizures were no reason to consider surgery as a failure. Among children who were free of both seizures and anti-epileptic drugs, 42% lived with restrictions.Conclusions: Epilepsy surgery that does not result in seizure freedom is nevertheless felt to be beneficial. Proper advice should prevent meaningless continuation of restrictions. (C) 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.