结节性硬化症的癫痫手术治疗对发作及智力影响的研究  

A clinical study of epilepsy surgery for the seizures and intellectual outcome： in patients with tuberous sclerosis complex

作　　者：石岩芳[1] 左焕琮[1] 周文静[1] 刘晓燕[2] 韩宏彦[1] 孙朝晖[1] 潘鑫[1] 林久銮[1] 张晗[3] 

机构地区：[1]清华大学玉泉医院癫痫中心,北京100049 [2]北京大学第一医院小儿神经科 [3]北京师范大学国家认知重点实验室

出　　处：《癫痫与神经电生理学杂志》2011年第3期137-140,161,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：基金项目：科技部基金（编号：2005CB522800,2004CB318101）;国家自然科学基金（编号：30621004）;清华一裕元科学研究基金

摘　　要：目的：探讨结节性硬化症TSC患者手术治疗癫痫对其远期疗效及智力的影响。方法：回顾性分析经手术治疗的9例伴癫痫的TSC患者的临床资料，总结发作症状学、EEG及头颅MRI的特点，随访远期发作的控制情况及智力水平。结果：术后随访24～30个月（平均26．1个月），EngleI级8例，EngleIV级1例。8例手术治疗有效的患者中，5例智力水平显著提高，IQ平均增高18．2，手术时平均年龄为5．7岁。3例无明显变化，IQ平均增高2．3，手术时平均年龄为20．3岁。结论：在一部分TSC患者，当发作症状、MRI上的结节的部位、EEG痼样放电的部位一致时，手术治疗能有效的控制发作。手术时年龄较小的患者随发作的控制智力改善明显。Objective： To explore the effect of surgical treatment for seizures and intellectual outcome in patients with tuberous sclerossis complex（TSC）. Methods： Nine patients with TSC underwent presurgical evaluation in Yuquan hospital, and all cases had a epileptogenic tuber resection and subsequently underwent a long-term follow-up. Results：The mean time of follow-up was 26.1 months： 8 patients became seizure free. Improved intelligence quotient （IQ） was found in 5 patients and the mean age during surgery was 5.7 years. IQ was not improved in 3 patients belonging to Engle I and the mean age during surgery was 20.3 years. Conclusion：Epilepsy surgery can successfully control seizures in patients in whom semiology. Video-EEG, location of tubers are concordant. Early control of seizures plays a crucial role in reducing cognitive consequences of seizures.

关 键 词：结节性硬化症(TSC) 癫痫 外科手术 智商(IQ) 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R744.5[医药卫生—临床医学]