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【medical-news】大脑半球切除术能改善难治性癫痫
By Martha Kerr
NEW YORK (Reuters Health) May 18 - Cerebral hemispherectomy for intractable epilepsy can benefit adults as well as children, according to findings from the first series to examine the benefits of this surgery in adults, reported in the April issue of the Annals of Neurology.
The series, reported by Dr. Shearwood McClelland, III, and Robert E. Maxwell at the University of Minnesota in Minneapolis shows that hemispherectomy improves functional status and quality of life in appropriately selected adults.
The investigators note that hemispherectomy has long been established for pediatric patients, but only a few case reports in adults have been published.
In their series of nine adult patients with intractable seizures, all had "severe hemiparesis consistent with severe unihemispheric damage," a nonfunctional "helper" hand, and homonymous hemianopsia.
Six patients have been followed for more than 30 years. Five of the six have remained seizure-free. There has been no surgery-related mortality, superficial cerebral hemosiderosis or hydrocephalus, Dr. McClelland told Reuters Health.
Only one patient, with mixed language dominance, developed permanent dysphasia, and another experienced worsening of preoperative hemiparesis.
Three patients are now employed, and all but one are living independently or with family.
Level of function and quality of life has improved in these patients "because hemispherectomy has eliminated chronic, intractable seizures," Dr. McClelland noted. He said success has been contingent upon strict selection criteria.
"This is a new finding, the first series to show positive benefits in adults. The point is, age should not be an issue in appropriately selected adults," Dr. McClelland said. "Patients should not be denied surgery because they are adults."
Ann Neurol 2007;61:372-376.
http://www.medscape.com/viewarticle/556959 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Hemispherectomy Can Improve Quality of Life in Adults With Intractable Seizures
大脑半球切除术能改善难治性癫痫成年患者的生活质量
By Martha Kerr
NEW YORK (Reuters Health) May 18 - Cerebral hemispherectomy for intractable epilepsy can benefit adults as well as children, according to findings from the first series to examine the benefits of this surgery in adults, reported in the April issue of the Annals of Neurology.
纽约，5月18日（路透社健康报道）——神经病学年鉴四月刊报道，依据首批成人外科治疗效果的调查结果，大脑半球切除术治疗难治性癫痫，成人患者能获得和儿童患者一样的效果。
The series, reported by Dr. Shearwood McClelland, III, and Robert E. Maxwell at the University of Minnesota in Minneapolis shows that hemispherectomy improves functional status and quality of life in appropriately selected adults.
明尼阿波利斯明尼苏达大学的Dr. Shearwood McClelland, III, and Robert E. Maxwell报道的一系列病例表明大脑半球切除术改善了适当地所选成年患者的功能状态和生活质量。
The investigators note that hemispherectomy has long been established for pediatric patients, but only a few case reports in adults have been published.
调查人员指出，大脑半球切除术已经确定用于儿科病人的治疗很长时间了，然而公布的用在成人身上的报道却很少。
In their series of nine adult patients with intractable seizures, all had "severe hemiparesis consistent with severe unihemispheric damage," a nonfunctional "helper" hand, and homonymous hemianopsia.
他们调查的9个难治性癫痫成年患者，都出现“符合严重共同偏瘫损害的严重偏瘫”，一只无功能的“辅助”手和同侧偏盲。
Six patients have been followed for more than 30 years. Five of the six have remained seizure-free. There has been no surgery-related mortality, superficial cerebral hemosiderosis or hydrocephalus, Dr. McClelland told Reuters Health.
6例患者已经随访了30多年。其中有5例保持无癫痫发作。Dr. McClelland告诉路透社健康报，患者没有手术相关性死亡、浅表大脑含铁血黄素沉着病或脑水肿等后遗症。
Only one patient, with mixed language dominance, developed permanent dysphasia, and another experienced worsening of preoperative hemiparesis.
只有1例有混和语言优势（半球）的患者发生永久性语言障碍，和另一例患者的术前偏瘫在术后加重。
Three patients are now employed, and all but one are living independently or with family.
其中，3例患者现在从业了，其他人（除外一例）也都可以独立生活或和家人一起生活。
Level of function and quality of life has improved in these patients "because hemispherectomy has eliminated chronic, intractable seizures," Dr. McClelland noted. He said success has been contingent upon strict selection criteria.
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作者:admin@医学,生命科学 2010-09-22 17:11
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