Greater functional recovery after temporal lobe epilepsy surgery in children
Greater functional recovery after temporal lobe epilepsy surgery in children
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DOI：
10.1093/brain/awh597
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发表时间：
2005-12-01
期刊：
影响因子：
14.5
通讯作者：
Helmstaedter, C
中科院分区：
文献类型：
--
作者：
Gleissner, U;Sassen, R;Helmstaedter, C
我们这项研究的目的是评估儿童是否比成人更好地从颞叶手术导致的记忆缺陷中恢复。我们比较了患有药物难治性癫痫的儿童和成人3个月和12个月的结果。每个候选人都接受了颞叶切除以控制癫痫发作，儿童在病理、癫痫发作、手术侧和成人手术类型方面匹配(每组N=30，手术时平均年龄13岁对30岁)。手术三个月后，两组左侧切除者的语言学习能力都出现了显著下降。在接下来的9个月中，仅有儿童在术后1年恢复并恢复到术前水平。左侧切除的成人大部分保持在低水平，手术后一年，他们仍然明显比他们术前检查时更糟糕。与短期随访结果相比，右侧切除的成人术后1年的视觉记忆力下降；儿童的视觉记忆有所改善。儿童在注意力功能方面也有更好的结果，作为一种趋势，癫痫的结果也更好(恩格尔结果I-术后1年：63%的成年人，80%的儿科患者)。我们的神经心理学数据提供了童年时期更大的可塑性和补偿能力的证据。这一结果可以作为早期手术干预的有力论据。
The purpose of our study is to evaluate whether children recover better than adults from memory deficits as a consequence of temporal lobe surgery. We compared 3 and 12 month outcomes obtained in children and adults with medically refractory epilepsy. Each candidate underwent temporal lobe resection for seizure control and children were matched with regard to pathology, onset of epilepsy, side of surgery and type of surgery with adults (N = 30 for each group, mean age at surgery 13 versus 30 years). Three months after surgery, both left-resected groups displayed a significant decline in verbal learning capacity. During the following 9 months, only the children recovered and were able to reach their preoperative level 1 year after surgery. The left-resected adults remained, for the most part, on their low level and one year after surgery, they were still significantly worse than at the time of their preoperative examination. The right-resected adults experienced a deterioration in visual memory 1 year after surgery relative to the results of the short-term follow-up; the children improved. The children also had a better outcome with regard to attentional functions and, as a trend, a better seizure outcome (Engel Outcome I-1 year after surgery: 63% adults, 80% paediatric patients). Our neuropsychological data provide evidence of greater plasticity and compensational capacity in childhood. The results can be taken as a strong argument for early surgical intervention.