基因性儿童癫痫的外科治疗

Surgical treatment in children with genetic epilepsy

癫痫是最常见的儿童神经系统疾病,基因异常是儿童癫痫最多见的病因之一。近年来国内外基因性儿童癫痫的外科治疗均取得了快速进步。该文就基因性儿童癫痫的手术适应证、基因异常与癫痫的关系评估及手术方式选择、切除性手术方式、神经调控手术方式及其他手术方式进行总结和述评。基因异常不会成为基因性儿童癫痫外科治疗的禁忌证,只是癫痫术前评估中一个重要的考虑因素,切除性手术和迷走神经刺激术是当前基因性儿童癫痫最常用的手术方案。正确选择的难治性基因性儿童癫痫患者行手术治疗效果良好。

Epilepsy is the most common neurological disease in childhood,and genetic abnormality is one of the most common causes.The surgical treatment in children with genetic epilepsy has made rapid progress in recent years.This paper summarizes and reviews the pediatric genetic epilepsy and its surgical indications,the evaluation of the relationship between genetic abnormality and epilepsy and selection of surgical approaches,resection surgery for pediatric genetic epilepsy,neuromodulation surgery for pediatric genetic epilepsy,and other surgical methods.It is concluded that genetic abnormality will not become a contraindication in the surgical treatment of pediatric genetic epilepsy,but will only become an important consideration in the preoperative evaluation.Resection surgery and vagus nerve stimulation are the most common used surgical approaches for genetic epilepsy in childhood.Surgical treatments can reach favorable outcomes in rational selected children with intractable genetic epilepsy.