儿童下丘脑错构瘤导致癫痫的手术治疗

目的 探讨儿童下丘脑错构瘤导致癫痫的手术治疗。方法 报告儿童下丘脑错构瘤11例，男6例，女5例，年龄为2-15岁，发病年龄为2个月至14岁。首发症状为痴笑样癫痫者10例。为癫痫大发作者1例，伴发性早熟6例，伴发跌倒发作3例，伴发癫痫大发作6例。手术；翼点入路10例，终板入路1例，术中错构瘤深部电极检测4例。结果 全切错构瘤2例，大部切除8例，部分切除1例。术中错构瘤深部电极显示棘波1例。随诊19至90个月，痊愈2例，有效9例，术后一过性动眼神经麻痹3例。结论 手术切除错构瘤可有效治疗儿童下丘脑错构瘤导致的癫痫。

Microsurgical treatment for hypothalamic hamartoma causing epilepsy in children

Objective To discuss the surgical treatment for hypothalamic hamartoma causing epilepsy in children.Methods 6 boys and 5 girls with epilepsy and hypothalamic hamartoma, age ranged from 2 15 years old, were reported.The oneset age were 2 months to 14 years old.10 patients presented with gelastic seizure, 6 of them also with generalized tonic clonic seizures and 3 with drop attacks, 1 patient with generalized tonic clonic seizure.All patients were treated microsurgically via a pterional approach except one via a laminaterminalis approach and 4 patients underwent depth electrode encephalography with electrodes implanted into the hypothalamic hamartoma.Results 2 hamartoma were totally removed without any sequela,the other 8 hamartomas were gross totally removed and 1 was partials removed.All patients were followed up by 19 to 90 months after operation, 2 were completely seizure free, 9 were significantly reduced the frequency of seizures.Conclusions Removal of hamartoma can effectively control the epilepsy caused by hypothalamic hamartoma in children.