Dwivedi R, et al. Surgery for drug-resistant epilepsy in children. N Engl J Med 2017;377:1639.47.In this single-center trial, the authors randomly assigned 116 patients who were 18 years of age or younger with drug-resistant epilepsy to undergobrain surgery appropriate to the underlying cause of epilepsy along with appropriate medical therapy (surgery group, 57 patients) or to receivemedical therapy alone (medical-therapy group, 59 patients). At 12 months, freedom from seizures occurred in 44 patients (77%) in the surgerygroup and in 4 (7%) in the medical-therapy group. Serious adverse events occurred in 19 patients (33%) in the surgery group, includinghemiparesis in 15 (26%). The authors concluded that children and adolescents with drug-resistant epilepsy who had undergone epilepsy surgeryhad a significantly higher rate of freedom from seizures and better scores with respect to behavior and quality of life than did those who continuedmedical therapy alone at 12 months. Surgery resulted in anticipated neurologic deficits related to the region of brain resection.
展开▼
机译：Dwivedi R等。儿童耐药性癫痫的手术。 N Engl J Med 2017; 377：1639.47。在这项单中心试验中，作者随机分配了116名年龄在18岁以下的耐药性癫痫患者进行脑外科手术，以适应引起癫痫的根本原因以及适当的医疗治疗（手术组57例）或仅接受药物治疗（药物治疗组59例）。在12个月时，手术组有44例患者（77％）出现癫痫发作，而药物治疗组有4例（7％）没有癫痫发作。手术组中有19名患者（33％）发生了严重的不良事件，其中包括15名偏瘫患者（26％）。作者得出的结论是，与仅接受药物治疗12个月的儿童和青少年相比，接受癫痫手术的儿童和青少年的癫痫发作自由度明显提高，并且行为和生活质量得分更高。手术导致与脑切除区域有关的预期神经功能缺损。
展开▼
