论文部分内容阅读
本文主旨在于总结儿童颞叶癫痫的病因学,并分析其与治疗效果之间的关系。通过回顾性总结在北京天坛医院治疗的46例儿童(小于16岁)颞叶癫痫病例,经综合评估、明确诊断后手术治疗。癫痫控制效果用Engel标准评估。在46例患者中,经MRI扫描、再经病理学确诊的“颞叶肿瘤”21例,“海马硬化”14例,颞叶“皮质发育不良”6例,颞叶“蛛网膜囊肿”5例。21例“颞叶肿瘤”患者中18例行肿瘤和周围皮质(11例患者累及颞叶内侧结构)扩大切除,3例仅切除肿瘤。14例“海马硬化”患者均行Spencer术式切除颞叶前部和颞叶内侧结构。6例“皮质发育不良”患者中4例行皮质切除术,2例行异常皮质和颞叶内侧结构切除。5例“蛛网膜囊肿”均行囊肿切除术。术后随访3~8年,Engel-I级33例、II级8例、III级4例、IV级1例。本文通过分析得出,颞叶结构异常、海马硬化是儿童颞叶癫痫的主要致痫病因,手术切除“异常结构”及周围致痫皮质,能取得满意的癫痫控制效果。
The purpose of this paper is to summarize the etiology of temporal lobe epilepsy in children and to analyze its relationship with the therapeutic effect. By retrospectively summarizing the cases of temporal lobe epilepsy in 46 cases of children (less than 16 years old) treated in Beijing Tiantan Hospital, the patients were diagnosed by postoperative comprehensive evaluation. Epilepsy control efficacy was assessed using the Engel criteria. In 46 patients, MRI scans, pathologically confirmed 21 cases of temporal lobe tumor, 14 cases of hippocampal sclerosis, 6 cases of temporal lobe and cortical dysplasia, “Arachnoid cyst” in 5 cases. Of the 21 patients with “temporal lobe tumor”, 18 had tumors and peripheral cortex (11 involving the medial temporal lobe), and only 3 had tumor resection. All 14 patients undergoing hippocampal sclerosis underwent Spencer operation to resect the anterior temporal lobe and the medial temporal lobe. Of the 6 patients with cortical dysplasia, 4 patients underwent cortical resection and 2 underwent abnormal cortical and temporal medial structures. 5 cases “arachnoid cyst ” cyst excision. The patients were followed up for 3 to 8 years. There were 33 cases of Engel-I grade, 8 cases of grade II, 4 cases of grade III and 1 case of grade IV. In this paper, the analysis of the temporal lobe structure abnormalities, hippocampal sclerosis is the main cause of epilepsy in temporal lobe epilepsy, surgical removal of “abnormal structure” and around the epileptic cortex, can achieve satisfactory control of epilepsy.