Individual Surgical Intervention And Prognosis Of Intractable Epilepsy Due To Congenital Brain Structural Abnormalities In Children

Objective To investigate the individual surgical interventions and prognosis of i ntractable epilepsy due to the congenital structural abnormalities,to analysis the t iming, operation mode, safety and effectiveness of the individual surgical interve ntions.Methods The clinical data of 17 children(age≤14 years old) who had got intra ctable epilepsy due to the congenital structural abnormalities of the brain and ac cepted individual surgical intervention treatment were analyzed retrospectively. All patients underwent imaging examination and video eletroencephalography (VEEG) monitoring before operation, if necessary, intraeranial EEG (IEEG, cortical electr odes or electrodes implanted in deep brain) examination to confirm the epileptog enic focus and functional areas, to design individual surgical interventions.17 pat ients consisted of 10 males and 7 females, the patient ages ranged from 2～14 y ears old.8 cases accepted epileptic foci resection,2 cases accepted epileptic foc i resection plus cortex thermocoagulation,4 cases accepted hippocampus resection, 2 cases accepted vagus nerve stimulation,1 accepted the anterior temporal lobe cortical resection and hippocampus resection. Engle grade was used to evaluate the surgical effect of the patients, and the IQ of the children was compared befo re and after operation.Results All postoperative patients were followed up for 13～68 months. At the end of follow-up the curative effect (Engle classifications) showed that,11 case s in grade Ⅰ (64.7%),4 cases in grade Ⅱ (23.5%),1 case in grade Ⅲ (5.9%),1 case in grade Ⅳ (5.9%),no long-term complication and dead cases. Evaluating by the Wechsler scales and Gesell development table before and after operation, it is found that both the IQ and the quality of life have improved apparently.Conclusions To record hippocampal EEG in patients with intractable epilepsy b y stereotactic implanting depth elcctrode into the hippocampus is a minimally inv asive, safe and accurate method to localize lateralize epileptogenic zones in patie nts with temporal lobe epilepsy.It has a decisive role in formulate individualized operation scheme.