小儿顽固性颞叶癫痫的病理特点研究

Pathology of intractable temporal lobe epilepsy in children

目的 研究小儿顽固性颞叶癫痫的临床病理学表现.方法 80例小儿顽固性颞叶癫痫患者行标准前颞叶切除术,切除组织送病理学检查.术后随访1-5年,根据Engel分级评估手术效果.结果 切除组织病理学表现以单纯海马硬化（26例）、良性肿瘤（20例）、局灶性皮层发育不良（10例）和海马硬化合并颞叶其他病变（9例）四大类型为主.癫痫发作控制结果提示EngelⅠ级58例,Ⅱ级11例,Ⅲ级6例,Ⅳ级5例.结论 小儿顽固性颞叶癫痫病理表现多样,以海马硬化、良性肿瘤和局灶性皮层发育不良最常见；颞叶切除疗效肯定；病理类型与手术效果之间的关系仍待更多研究.

Objective To study the pathology of intractable temporal lobe epilepsy in children.Method 80 children with intractable temporal lobe epilepsy underwent anterior temporal lobe resection.All samples underwent routine histological study.All patients were followed - up from one to five years after operations.The effects of operation were evaluated with Engel class.Results The major pathological findings in these patients included：isolated hippocampal sclerosis （ n =26）,benign tumors （ n =20）,FCD （ n =10） and hippocampal sclerosis with other lesions （ n =9）.Mter surgery,58 patients were Engel class Ⅰ,11 class Ⅱ,6 class Ⅲ and 5 class Ⅳ.Conclusions There are many pathological findings in intractable temporal lobe epilepsy in children,and hippocampal sclerosis,benign tumors and FCD are the most commonly seen.Anterior temporal lobe resection could achieve excellent seizure control.The connection between the pathological lesions and surgical effects should be paid attention for further study.