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目的探讨儿童后象限脑皮质发育障碍致难治性癫癎的临床特点、手术策略及疗效。方法分析14例后象限皮质发育不良(PQD)致难治性癫癎患儿的症状学特征及术前评估结果,总结视频脑电图检查、术中监测的定位价值及颞顶枕叶离断术的适应症和优缺点。结果 14例PQD患儿的癫癎发作有多种发作形式,但以痉挛发作最常见。2例皮质发育不良涉及中央区。14例患儿行颞顶枕叶离断手术,术后13例无发作,1例发作减少>50%。结论颞顶枕叶离断术是儿童后象限皮质发育障碍所致难治性癫癎外科手术治疗较安全的一种术式,并获得了满意的癫癎控制效果。
Objective To investigate the clinical features, surgical strategies and curative effects of refractory epilepsy in children with posterior cerebral cortex dysfunction. Methods The symptoms and preoperative evaluation results of 14 cases with post-quadrant quadri-quadrant cortical dysplasia (PQD) induced by refractory epilepsy were analyzed. The results of video-EEG, intraoperative monitoring and temporal lobe occipital lobe disconnection The indications and advantages and disadvantages of surgery. Results 14 cases of PQD children with epileptic seizures have a variety of seizures, but the most common seizures. 2 cases of cortical dysplasia involving the central area. Fourteen children underwent temporal top occipital lobe surgery, with 13 episodes of no seizures and one episode of seizures reduced by> 50%. Conclusion Temporal lobe occipital lobectomy is a safe surgical procedure for intractable epilepsy in children with posterior quadrant cortical dysplasia, and satisfactory epilepsy control is obtained.