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Kết quả điều trị động kinh kháng thuốc bằng phẫu thuật cắt liên kết bán cầu tại Bệnh viện Nhi Trung ương

Bài viết Kết quả điều trị động kinh kháng thuốc bằng phẫu thuật cắt liên kết bán cầu tại Bệnh viện Nhi Trung ương nghiên cứu kết quả điều trị ở nhóm bệnh nhân trẻ em được điều trị cắt liên kết bán cầu chức năng tại Bệnh viện Nhi Trung ương nhằm mục đích đánh giá kết quả điều trị phẫu thuật. | Journal of Pediatric Research and Practice Vol. 6 No. 3 4 2022 86-91 Research Paper Results of Hemispherotomy Surgery for Intractable Epilepsy at the Vietnam National Children s Hospital Le Tuan Anh Ho Trung Luan Le Nam Thang Vietnam National Children s Hospital 18 879 La Thanh Dong Da Hanoi Vietnam Received 24 April 2022 Revised 5 May 2022 Accepted 12 May 2022 Abstract Overview Intractable epilepsy affects a substantial minority of patients but imposes a significant challenge in management. Neurosurgery constitutes the best treatment of choice when AED is not effective. Hemispherotomy is a good option for diffuse unilateral hemispheric involvement and now becoming more common. Since the first surgery in 2016 we retrospectively evaluated the surgical outcome of patients who underwent hemispherotomy in the Vietnam National Children s Hospital. Objective We sought to determine the surgical outcome of hemispherotomy in disabling seizure in the group of patients who had surgical indication for intractable epilepsy. Methods We conducted a retrospective observational study at the Vietnam National Children s Hospital. Patients who underwent hemispherotomy during 2016 - 2022 were enrolled. We collected patients information through medical records include demographic characteristicspre- and post-operative radiography imaging pre-operative clinical status and 3 month-postoperative follow up for evaluating treatment outcomes. Results Male was predominance with male female ratio was 10 2. The median age at surgery was 3.9 3.3 years old IQR the median duration of epilepsy prior to surgery was 2.62 2.29 years IQR . Neonatal onset seizure accounted for the highest rate 50 . Pre-operative diagnosis was hemimegalencephaly 58.3 Rasmussen s encephalitis 16.7 and secondary cerebral atrophy 16.7 . The vast majority of cases 91.6 showed abnormality in magnetic resonance imaging. Vertical hemispherotomy was performed in five patients 41.7 and peri-insular hemispherotomy in seven .