根據(jù)一項(xiàng)最新研究，一種新型外科手術(shù)使用非創(chuàng)傷性顱內(nèi)監(jiān)測(cè)方法，能夠減少患結(jié)節(jié)硬化癥(TSC)兒童癲癇發(fā)作頻率。

在該研究中，New York大學(xué)醫(yī)學(xué)中心(NYU, USA)的研究人員，進(jìn)行了25例TSC患者手術(shù)切除結(jié)節(jié)的手術(shù)，中位數(shù)年齡為4歲。在NYU小組進(jìn)行的第一階段，放置了電極以鑒別原發(fā)性和繼發(fā)性癲癇位點(diǎn)。在第二階段，這些癲癇位點(diǎn)被切除。在第三階段，在所有被發(fā)現(xiàn)的癲癇位點(diǎn)被切除之后再次植入電極。

22例患者接受了三個(gè)階段的外科手術(shù)，3例接受了2個(gè)階段的手術(shù)。13例患者放置了兩側(cè)電極，12例放置了單側(cè)電極。在手術(shù)后6個(gè)月，21例兒童沒用癲癇發(fā)作，只有1例出現(xiàn)非致殘的部分發(fā)作。其余兒童包括兩例癲癇發(fā)作減少了90%以上，2例減少了50%。因?yàn)槭嵌辔稽c(diǎn)癲癇發(fā)作，5例兒童中有4例開始并沒用作為手術(shù)候選人，在多階段手術(shù)后癲癇不再發(fā)作。這些結(jié)果發(fā)表在20065月的《兒科學(xué)》之上。

Multifocal Brain Surgery Reduces Epileptic Seizures
 
A new surgical approach using invasive intracranial monitoring can reduce seizure frequency in children with tuberous sclerosis complex (TSC), according to a new study.

In the study, conducted by researchers from New York University Medical Center (NYU, USA), 25 TSC patients with a median age of four years underwent surgical removal of the tubers. In the first stage of the approach developed by the NYU team, electrodes are placed to identify primary and secondary epileptic foci.

In the second stage, these foci are resected. With a third stage, electrodes are reimplanted after resection and any residual foci identified are resected. Twenty-two of the patients underwent a three-stage surgical approach and three had a two-stage approach. Thirteen of the patients had bilateral electrode placement and 12 had unilateral placement. At six months or longer following surgery, 21 of the children were seizure-free or had only non-disabling simple partial seizures. The remaining children included two who experienced a higher-than-90% drop in seizure frequency and two with a lower-than-50% reduction in frequency. Four of five children who were not originally considered candidates for surgery, due to multiple seizure foci, were rendered seizure-free with the multi-stage approach. The results were reported in the May 2006 issue of Pediatrics.