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.