雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 47, Issue 3 （March 2019）

Neurological Surgery 脳神経外科 47巻3号（2019年3月発行）

Japanese English

症例

Posterior quadrantectomyが有効であった難治性てんかんの乳児例 Posterior Quadrantectomy for Infant with Refractory Epilepsy:A Case Report 齋藤太希 ¹ , 大石誠 ¹ , 福多真史 ³ , 塚本佳広 ¹ , 大橋伯 ² , 渡邉潤 ¹ , 根元琢磨 ¹ , 川口正 ⁴ , 藤井幸彦 ¹ Taiki SAITO ¹ , Makoto OISHI ¹ , Masafumi FUKUDA ³ , Yoshihiro TSUKAMOTO ¹ , Tsukasa OHASHI ² , Jun WATANABE ¹ , Takuma NEMOTO ¹ , Tadashi KAWAGUCHI ⁴ , Yukihiko FUJII ¹ ¹新潟大学脳研究所脳神経外科学分野 ²新潟大学医歯学総合病院小児科学分野 ³国立病院機構西新潟中央病院機能脳神経外科 ⁴長岡赤十字病院脳神経外科 ¹Department of Neurosurgery, Brain Research Institute, Niigata University ²Department of Pediatrics, Niigata University Medical ＆ Dental Hospital ³Department of Neurosurgery, Nishi-Niigata Chuo National Hospital ⁴Department of Neurosurgery, Nagaoka Red Cross Hospital キーワード： posterior quadrantectomy , linear nevus sebaceous syndrome , cortical dysplasia , West syndrome , intractable epilepsy Keyword: posterior quadrantectomy , linear nevus sebaceous syndrome , cortical dysplasia , West syndrome , intractable epilepsy pp.349-356

発行日 2019年3月10日 Published Date 2019/3/10

DOI https://doi.org/10.11477/mf.1436203943

PDF(2532KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference

Ⅰ．はじめに

　側頭頭頂後頭葉離断術（posterior quadrantectomy：PQ）は，2007年にDanielらが報告¹⁾して以降，広汎な一側の大脳半球に焦点を有する難治性てんかんに対して，機能を温存しつつ焦点を離断できるため，徐々に適応が広がってきている．

　今回われわれは，右側頭葉から後頭葉にかけての皮質形成異常に起因した難治性てんかんを有する線状脂腺母斑症候群（linear nevus sebaceous syndrome：LNSS）の小児例に対し，PQを施行した1例を経験したのでこれを報告する．

　We present the case of an 11-month-old girl with linear nevus sebaceous syndrome who underwent posterior quadrantectomy（PQ）for intractable epilepsy due to cortical dysplasia extending from the temporal, parietal, and occipital lobes in the right hemisphere. Epileptic spasms started at 4 months after birth, and the frequency of her seizures gradually increased to 10 episodes per day. Electroencephalograms in the interictal periods showed hypsarrhythmia. Magnetic resonance imaging（MRI）suggested cortical dysplasia in the right temporal, parietal, and occipital lobes. Ictal single-photon emission computed tomography revealed increased cerebral blood flow in similar areas as the cortical dysplasia suggested on MRI. Several antiepileptic drugs were administered to control the epileptic spasms, without success. In addition, her developmental delay gradually became evident. Because the epileptic foci extended into the posterior region of the right hemisphere, we did not execute a focused resection, but performed a PQ. The epileptic spasms completely disappeared after surgery and her developmental delay gradually improved. Early surgical intervention via PQ is useful in patients with drug-resistant epilepsy in whom the epileptic foci have extended into the temporal, parietal, and occipital lobes. This intervention not only controls intractable seizures but also helps to facilitate normal development.