手术治疗裂脑患儿局灶性癫痫三例报告并文献复习

Surgical treatment of Focal Epilepsy in childhood with Schizencephaly

目的报告3例裂脑病儿局灶性癫痫并文献回顾。方法3例男性患儿，平均年龄13．3岁，癫痫发作平均为4．3年，均为右利手。所有患儿术前根据临床表现、神经影像、脑电图、神经心理学评定，诊断为裂脑畸形，均行开颅手术切除病变的裂脑。结果3例术后恢复良好，无癫痫发作。病理证实为裂脑。结论临床证实难治性癫痫患儿的痫灶为局灶性起源及裂脑畸形。在皮质脑电图监测下彻底切除病变，是有效的治疗方法。

Objective To report three children suffered from focal epilepsy with schizencephaly treated surgically and review the correlative literature. Methods 3 male children were right -handed. the average age was 13.3 years and the epileptic attack was 4. 3 years on average. All the children were diagnosed with schizencephaly malformation preoperatively, viz. according to the clinical manifestation, epileptic attack, neuroimaging, EEG, and the assessment of neuropsychology. The epileptogenic lesions were resected through eraniotomy. Results Total resection was achieved and the seizure disappeared postoperatively. All the lesions were confirmed as the schizencephaly. Conclusion The epileptic focus of refractory epilepsy in children was originated from schizencephaly, surgery should be seriously considered as an effective method by using minimally invasive technique and cortical -EEG monitoring.