论文部分内容阅读
目前国内外对儿童难治性癫癎的诊断缺乏统一标准。国内建议的诊断标准为癫癎患儿经应用正规的抗癫癎药物(2种以上)合理治疗6个月~1 a,发作仍未能减少50%者定为儿童难治性癫癎。国外文献中,因儿童癫癎类型和研究目的不同,其所制定的诊断标准也各有不同,在诊断标准中均包含4个因素:抗癫癎药物无效;惊厥发作的频率;治疗无效的持续时间;惊厥缓解期的持续时间。亦有认为2种选择正确的抗癫癎药物治疗无效;惊厥发作平均每月1次,持续≥18个月;在该18个月中,惊厥缓解期的持续时间≤3个月考虑药物难治性癫癎。目前国内外公认的儿童难治性癫癎的治疗方案有3种选择:1.调整抗癫癎药物或其他药物,如激素和静脉注射用丙种球蛋白;2.外科治疗,包括治疗性手术(如局灶切除术和大脑半球切除术)和姑息性手术(如胼胝体切除术和迷走神经刺激);3.生酮饮食。
At present, the diagnosis of intractable epilepsy in children lacks a unified standard. The recommended diagnostic criteria for children with epilepsy after the use of formal anti-epileptic drugs (2 or more) reasonable treatment of 6 months to 1 a, the attack has not been reduced by 50% were defined as children with refractory epilepsy. Foreign literature, due to the different types of epilepsy and research purposes, the diagnostic criteria developed by the diagnostic criteria are different, including four factors in the diagnostic criteria: antiepileptic drugs ineffective; frequency of seizures; duration of treatment is invalid Time; convulsive duration of remission. There are also two options for the correct treatment of antiepileptic drugs ineffective; seizures average 1 per month, lasting ≥ 18 months; in the 18 months, the duration of the convulsive remission period ≤ 3 months to consider the drug refractory Sexual epilepsy. Currently recognized treatment of childhood refractory epilepsy program has three options: 1. Adjust the anti-epileptic drugs or other drugs, such as hormones and intravenous gamma globulin; 2. Surgical treatment, including therapeutic surgery ( Such as focal resection and hemispherectomy) and palliative surgery (such as corpus callosum and vagus nerve stimulation); 3 ketogenic diet.