婴幼儿难治性癫痫的早期外科治疗对智力的影响

目的 探讨婴幼儿难治性癫痫外科手术的适应证、方法 和预后.方法 回顾性分析了2000年1月至2008年1月间,采用外科手术治疗54例婴幼儿难治性癫痫的经验. 结果 术后疗效按Engel分级,Ⅰ级为18例,Ⅱ级15例,Ⅲ级13例,Ⅳ级8例,有效率为81.5%,优良率61.1%.术后1～2年智力检查Gesell评分大多有不同程度的提高. 结论 外科手术是治疗婴幼儿难治性癫痫的良好手段.对于智力发育停滞或恶化的婴幼儿癫痫患者,如果临床判断有难治倾向应考虑进行外科治疗.

Epilepsy surgery in infants

Objective To investigate the etiology of intractable epilepsy in infants, and to study the surgical indications, procedures and clinical outcomes of epilepsy surgery in infants with intractable epilepsy. Methods Between 2000 and 2008, the etiology, surgical indications, procedures and clinical outcomes of epilepsy surgery in 54 infants were retrospectively analyzed. Results Malformation of cortical development and cortical dysplasia were the predominant causes of pediatric intractable epilepsy. After surgery, all patients were followed up for 3 years in average. The surgical efficacy was evaluated using Eagel criterion: Engel Class I was achieved in 18 patients, Engel ClassⅡ in 15 (rare seizure), and Engel Class III in 13 (less frequent seizures). The intellectual ability was assessed using Gesell developmental quotient (DQ). Most patients' intellectual abilities were improved 1-2 years' after surgery. Conclusions Surgery is a good option for the infants with intractable epilepsy, especially for the patients with delayed intelectual ability development.