Surgical treatment of patients with Lennox-Gastaut syndrome phenotype.
Surgical treatment of patients with Lennox-Gastaut syndrome phenotype.
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Lennox-Gastaut 综合征表型患者的手术治疗
DOI：
10.1100/2012/614263
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发表时间：
2012
影响因子：
--
通讯作者：
Yang H
中科院分区：
文献类型：
--
作者：
Liu SY;An N;Fang X;Singh P;Oommen J;Yin Q;Yang MH;Liu Y;Liao W;Gao CQ;Yang H
Lennox-Gastaut综合征（LGS）是一种影响儿童和青少年的破坏性和难治性全身性癫痫。在这项研究中，我们报告了18例LGS表型患者的切除手术结果，这些患者接受了单叶/病变切除术或多叶切除术加多软膜下横切术和/或胼胝体切开术。手术后，7名患者完全无结石（Engel I级），5名患者几乎无结石（Engel II级）。另外4例癫痫发作得到显著控制（恩格尔III级），2例癫痫发作频率无变化（恩格尔IV级）。4例MRI无病变者中，Engel Ⅱ级2例，Ⅲ级1例，Ⅳ级1例。平均智商（IQ）由术前56.1 ± 8.1（mean ± SD）提高到术后67.4 ± 8.2（mean ± SD），差异有统计学意义（P = 0.001）。结果还表明，手术时患者年龄越小，或癫痫发作和切除手术之间的间隔时间越短，智力结果越好。我们的数据表明，切除性癫痫手术可以成功的患者与LGS表型只要脑电图显示优势的放电在一个半球和相应的同侧的成像结果，即使对侧发作放电。
Lennox-Gastaut syndrome (LGS) is a devastating and refractory generalized epilepsy affecting children and adolescents. In this study we report the results of resective surgery in 18 patients with LGS phenotype who underwent single-lobe/lesionectomy or multilobe resection plus multiple subpial transection and/or callosotomy. After surgery, seven patients became completely seizure-free (Engel Class I) and five almost seizure-free (Engel Class II). Additional four had significant seizure control (Engel Class III), and two had no change in seizure frequency (Engel Class IV). Of the 4 patients without any lesion on brain MRI, 2 ended with Engel Class II, 1 with III and the other with IV in Engels' classification. Mean intelligence quotient (IQ) increased from 56.1 ± 8.1 (mean ± SD) before operation to 67.4 ± 8.2 (mean ± SD) after operation, a significant improvement (P = 0.001). Results also indicated that the younger the patient at surgery, or the shorter the interval between onset of seizure and resective operation, the better the intellectual outcome. Our data suggest that resective epilepsy surgery can be successful in patients with LGS phenotype as long as the EEG shows dominance of discharges in one hemisphere and corresponding ipsilateral imaging findings, even with contralateral ictal discharges.
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