Data were collected retrospectively from 4 large tertiary centers for children (< 18 years of age) who underwent resection of a supratentorial extratemporal (STET) LGG. The patients were divided into 4 groups based on preoperative seizure history: no seizures, up to 2 seizures, more than 2 seizures, and uncontrolled or refractory epilepsy. The authors analyzed the postoperative occurrence of seizures and the need for antiepileptic drugs (AEDs) over time for the various subgroups.
The study included 98 children. Thirty patients had no preoperative seizures, 18 had up to 2, 16 had more than 2, and 34 had refractory or uncontrolled epilepsy. The risk for future seizures was higher if the patient had seizures within 1 month of surgery. The risk for new-onset seizures among patients with no seizures prior to surgery was low. The rate of seizures decreased over time for children with uncontrolled or refractory seizures. The need for AEDs was higher in the more active preoperative seizure groups; however, it decreased with time.
The resection of STET LGGs in children is associated with a low rate of postoperative new-onset epilepsy. For children with preoperative seizures, even with uncontrolled epilepsy, most have a significant improvement in the seizure activity, and many may be weaned off their AEDs.
回顾性收集了4个大型三级中心的儿童(<18岁)的数据,这些儿童接受了幕上颞外(STET)LGG切除术。根据术前癫痫病史将患者分为4组:无癫痫发作,多达2次癫痫发作,超过2次癫痫发作,不受控制或难治性癫痫。作者分析了不同亚组术后癫痫发作的发生情况以及随着时间的推移对抗癫痫药物(AEDs)的需求。
这项研究包括98名儿童。30例患者术前没有癫痫发作,18人最多2人,16人超过2人,34人难治性或不受控癫痫。如果患者在手术后1个月内癫痫发作,未来癫痫发作的风险更高。在手术前没有癫痫发作的患者中,新发癫痫发作的风险很低。对于不受控制或难治性癫痫发作的儿童,癫痫发作率随着时间的推移而下降。在更活跃的术前癫痫发作组中,对AED的需求更高;然而,它随着时间的推移而减少。
儿童STETLGGs的切除与术后新发癫痫的低发生率相关。对于术前癫痫发作的儿童,即使患有不受控制的癫痫,大多数癫痫发作活动都有显著改善,许多人可能会戒掉他们的AED。