난치성 소아 간질의 수술적 치료 : 단일 기관에서의 경험
Surgical Treatments of the Pediatric Intractable Epilepsy : A Single Center Experience
김덕수, 고태성, 이정교,
소속 상세정보
김덕수 ( Kim Deok-Soo )
성균관대학교 의과대학 강북삼성병원 소아과학교실
고태성 ( Ko Tae-Sung )
울산대학교 의과대학 서울아산병원 소아과학교실
이정교 ( Lee Jung-Kyo )
울산대학교 의과대학 서울아산병원 신경외과학교실
KMID : 0877220050090010072
Abstract
Purpose: This study evaluates and compares the surgical outcomes of pediatric intractable epilepsy from various surgical modalities.
Methods: Among the patients who underwent epileptic surgery from March 1996 to February 2001, only the children, who had at least one year follow-up, were included in this study. The mean age with first seizure attacks was 3.5 years. The interval between first seizure attacks and surgical treatment was 4.8 years on average, and the mean age at surgical management was 7.4 years. The possible etiology was observed in 75.4% of total patients. Brain tumor and cortical dysplasia were main causes. The surgical treatment was done with various modalities, including resective surgeries (49.2%), corpus callosotomy of disconnection methods (41.5%), combined surgeries (7.7%), and gamma knife radiosurgery (one case).
Results: Surgical outcomes were evaluated based on the Engel’s classification. After resective surgery, 90.6% of the patients showed class I. The majority of corpus callosotomy (59.3%) had class III. The outcomes after combined surgeries ranged from class I to III. The result of gamma knife radiosurgery was class III. The pathologic findings from resected tissue showed cortical dysplasia, tumor, nonspecific gliosis, etc. The complications after surgery were transient or permanent hemiparesis, visual field defect, hydrocephalus, subdural effusion, etc.
Conclusion: We performed the various surgical methods in children with medically intractable epilepsy and obtained different results by surgical modalities. The surgical outcome will be improved if there is an appropriate selection among surgical modalities through the various preoperative assessments.
키워드
Pediatric Intractable Epilepsy ; Surgical outcome
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