Surgical treatment of refractory epilepsy

被引:10
作者
Shields W.D. [1 ]
机构
[1] Division of Pediatric Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095
关键词
Temporal Lobe Epilepsy; Tuberous Sclerosis Complex; Vigabatrin; Intractable Epilepsy; Infantile Spasm;
D O I
10.1007/s11940-996-0027-5
中图分类号
学科分类号
摘要
The extension of cortical resection to treat children with intractable epilepsy is one of the most exciting advances in pediatric neurology in the past two decades. Many children with epilepsy who previously had little hope have been given a new chance at life. Many patients who were not considered for surgery are now recognized to be excellent surgical candidates. Most notably, children with generalized seizures such as infantile spasms or gelastic seizures caused by hypothalamic hamartomas now have the opportunity to benefit from surgery. In adults, there is one goal for epilepsy surgery: freedom from seizures. This is an important goat but it is not the only one in children. It may not even be the most important goat. When operating on young children with epilepsy, we seek to alter the long-term developmental and behavioral outcome. Although there are many significant recent advances in pediatric epilepsy surgery, three are particularly important. These are 1) hemispherotomy for children who require hemispheric resection; 2) resection of hypothalamic hamartomas through an innovative transcallosal approach; and 3) resection of multiple tubers in children with tuberous sclerosis complex. Copyright © 2004 by Current Science Inc.
引用
收藏
页码:349 / 356
页数:7
相关论文
共 29 条
[1]  
Bailet L.L., Turk W.R., The impact of childhood epilepsy on neurocognitive and behavioral performance: A prospective longitudinal study, Epilepsia, 41, pp. 426-431, (2000)
[2]  
Hershey T., Craft S., Glauser T.A., Hale S., Short-term and long-term memory in early temporal lobe dysfunction, Neuropsychology, 12, pp. 52-64, (1998)
[3]  
Donner E.J., Smith C.R., Snead III O.C., Sudden unexplained death in children with epilepsy, Neurology, 57, pp. 430-434, (2001)
[4]  
Clusmann H., Kral T., Gleissner U., Et al., Analysis of different types of resection for pediatric patients with temporal lobe epilepsy, Neurosurgery, 54, pp. 847-859, (2004)
[5]  
Kossoff E.H., Vining E.P., Pillas D.J., Et al., Hemispherectomy for intractable unihemispheric epilepsy etiology vs outcome, Neurology, 61, pp. 887-890, (2003)
[6]  
Mathern G.W., Giza C.C., Yudovin S., Et al., Postoperative seizure control and antiepileptic drug use in pediatric epilepsy surgery patients: The UCLA experience, 1986-1997, Epilepsia, 40, pp. 1740-1749, (1999)
[7]  
Hermann B., Seidenberg M., Bell B., Et al., The neurodevelopmental impact of childhood-onset temporal lobe epilepsy on brain structure and function, Epilepsia, 43, pp. 1062-1071, (2002)
[8]  
Holmes G.L., Ben-Ari Y., Seizures in the developing brain: Perhaps not so benign after all, Neuron, 21, pp. 1231-1234, (1998)
[9]  
Devlin A.M., Cross J.H., Harkness W., Et al., Clinical outcomes of hemispherectomy for epilepsy in childhood and adolescence, Brain, 126, pp. 556-566, (2003)
[10]  
Lendt M., Gleissner U., Helmstaedter C., Et al., Neuropsychological outcome in children after frontal lobe epilepsy surgery, Epilepsy Behav., 3, pp. 51-59, (2002)