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Neurology：儿童局限性脑皮质发育不良临床表现和手术效果

2016-07-31 MedSci MedSci原创

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为了评估手术治疗儿童局限性脑皮质发育不良(FCD)的临床效果和结局，进行了一项回顾性研究。 回顾了75个术后经病理证实为FCD 的病例。国际抗癫痫联合会的标准进行病理分类，同时分析临床资料和癫痫及神经发育结局。 11个病例为 FCD I型，34个位IIa，19个为IIb，11个为III。51个(68.0%)病例临床表现为局灶癫痫 (FE) ，24个(32.0%)为癫痫脑病(EE)，包含

为了评估手术治疗儿童局限性脑皮质发育不良(FCD)的临床效果和结局，进行了一项回顾性研究。

回顾了75个术后经病理证实为FCD 的病例。国际抗癫痫联合会的标准进行病理分类，同时分析临床资料和癫痫及神经发育结局。

11个病例为 FCD I型，34个位IIa，19个为IIb，11个为III。51个(68.0%)病例临床表现为局灶癫痫 (FE) ，24个(32.0%)为癫痫脑病(EE)，包含16个Lennox-Gastaut综合征和8个West综合征。我们观察到 EE 中有7 个 (63.6%) 病例是FCD I型, 14 (41.2%) 个病例是 IIa, 2 (10.5%) 个病例为 IIb,以及 1 (9.1%) 个为 III型。 我们发现以下情况更容易出现EE：小于2岁时出现癫痫发作 (EE: 20 [83.3%], FE: 19 [37.3%]; p < 0.001), 术前出现智力障碍， (EE: 22 [91.7%], FE: 29 [56.9%]; p = 0.003), 多叶切除 (EE: 19 [79.2%], FE: 15 [29.4%]; p < 0.001)。48个(64.0%) 病例无癫痫发作;  FE,66.7% (34/51) ；EE，58.3% (14/24) 。无癫痫发作组较有癫痫发作组神经发育水平提高较多 (11/48 vs 0/27, p = 0.011) 和恶化较少 (2/48 vs 9/27, p = 0.001) 。

结论：FCD可以导致儿童时期局灶癫痫和癫痫脑病，手术切除可作为两种癫痫类型的治疗选择。

原始出处：

Kwon HE1, Eom S1, Kang HC1, Lee JS1,et al,Surgical treatment of pediatric focal cortical dysplasia: Clinical spectrum and surgical outcome,Neurology. 2016 Jul 27. pii: 10.1212/WNL.0000000000003042. [Epub ahead of print]


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    2017-02-22 haouestc

    #局限性#

    0

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    2016-08-24 yinhl1978

    #Neurol#

    0

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    2016-10-04 智慧医人

    #脑皮质#

    0

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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-10-11 ylzr123

    学习了，好文值得点赞！

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-10-09 1e10c84am36(暂无匿称)

    文章很好，继续关注

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-08-04 小小蚱蜢

    手术切除？怎么定位病变脑组织

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-08-02 neurowu

    #发育#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1924012, encodeId=cde31924012c0, content=<a href='/topic/show?id=61d24e655df' target=_blank style='color:#2F92EE;'>#局限性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47655, encryptionId=61d24e655df, topicName=局限性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Wed Feb 22 05:42:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999736, encodeId=47ce1999e36b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, 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likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed231670966, createdName=小小蚱蜢, createdTime=Thu Aug 04 17:37:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347107, encodeId=b41f134e10750, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567948, encodeId=b932156e94843, content=<a href='/topic/show?id=7a833e94079' target=_blank style='color:#2F92EE;'>#发育不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37940, encryptionId=7a833e94079, topicName=发育不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30b515313716, createdName=villahu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95227, encodeId=fc899522e72, content=厉害的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 31 11:22:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95209, encodeId=2d829520983, content=关爱儿童健康，这是祖国的未来, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-08-02 villahu

    #发育不良#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1924012, encodeId=cde31924012c0, content=<a href='/topic/show?id=61d24e655df' target=_blank style='color:#2F92EE;'>#局限性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47655, encryptionId=61d24e655df, topicName=局限性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Wed Feb 22 05:42:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999736, encodeId=47ce1999e36b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, 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likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed231670966, createdName=小小蚱蜢, createdTime=Thu Aug 04 17:37:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347107, encodeId=b41f134e10750, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567948, encodeId=b932156e94843, content=<a href='/topic/show?id=7a833e94079' target=_blank style='color:#2F92EE;'>#发育不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37940, encryptionId=7a833e94079, topicName=发育不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30b515313716, createdName=villahu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95227, encodeId=fc899522e72, content=厉害的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 31 11:22:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95209, encodeId=2d829520983, content=关爱儿童健康，这是祖国的未来, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-07-31 oo902

    厉害的研究

    0

  10. 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likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed231670966, createdName=小小蚱蜢, createdTime=Thu Aug 04 17:37:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347107, encodeId=b41f134e10750, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567948, encodeId=b932156e94843, content=<a href='/topic/show?id=7a833e94079' target=_blank style='color:#2F92EE;'>#发育不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37940, encryptionId=7a833e94079, topicName=发育不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30b515313716, createdName=villahu, createdTime=Tue Aug 02 01:42:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95227, encodeId=fc899522e72, content=厉害的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 31 11:22:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95209, encodeId=2d829520983, content=关爱儿童健康，这是祖国的未来, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b09f1636586, createdName=onetree, createdTime=Sun Jul 31 11:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=)]
    2016-07-31 onetree

    关爱儿童健康，这是祖国的未来

    0

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