Clinical analysis of 27 preschoolers with refractory temporal lobe epilepsy
10.3760/cma.j.cn115354-20201027-00849
- VernacularTitle:27例学龄前难治性颞叶癫痫患儿临床报道
- Author:
Xiaodong GUO
1
;
Xiaoqi LU
;
Zhenhua WANG
;
Peng XU
;
Minghui LIU
;
Wenming HAO
;
Xinchao YANG
;
Junlong LI
;
Jinglun LI
;
Anhui YAO
;
Benhan WANG
Author Information
1. 解放军联勤保障部队第九八八医院全军神经外科中心，郑州 450042
- Keywords:
Temporal lobe epilepsy;
Children;
Anterior temporal lobectomy;
Electrocorticography
- From:
Chinese Journal of Neuromedicine
2021;20(1):65-70
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the imaging and electrophysiological characteristics, surgical methods and efficacies of preschoolers with refractory temporal lobe epilepsy.Methods:A retrospective data study was conducted on 27 patients with refractory temporal lobe epilepsy accepted surgical treatment in our hospital from June 2014 to January 2019. By combined with clinical manifestations, preoperative epileptogenic zones were evaluated by imaging data, such as MR imaging, MR spectroscopy and positron emission tomography-CT, and interictal and ictal video-electroencephalogram (VEEG) data. During the surgery, cortical electroencephalography (ECoG) and deep electrode monitoring were used to monitor and locate the abnormal discharge areas to guide the surgical excision of epileptic zone. Engel grading was used to evaluate the efficacy after surgery.Results:All children had typical clinical manifestations of temporal lobe epilepsy; abnormal signal images were found in one side of the temporal lobe and the hippocampus in MR imaging; epileptic discharges were originated from one side frontotemporal region in interictal and ictal VEEG. Obviously persistent or paroxysmal spike waves, spike waves and slow spikes and spike composite waves were intraoperatively discovered by ECoG and depth electrode electroencephalography in the temporal lobe. All patients accepted standard anterior temporal lobectomy+lesion resection+peripheral abnormal discharge resection of the temporal lobe cortex; partial insular lobe was excised and frontal cortex was performed low power thermal coagulation in two patients. Follow-up was performed for 6 months; Engel grading I was reported in 22 patients (81.5%), Engel grading II in 3 patients (11.1%), and Engel grading III in 2 patients (7.4%).Conclusion:Early surgery and moderate extension of resection under intraoperative ECoG and deep electrode monitoring are the key factors to improve the surgical efficacy of preschoolers with refractory temporal lobe epilepsy.
