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Objective To analyze the outcome of reoperation in drug resistant epilepsy after failed surgery or recurrence in children,and to identify the predictors of the outcome of reoperation and inspiration of epilepsy resection surgery.Methods Analysis was done on data of 4 patients with drug resistant epilepsy diagnosed in Department of Neurosurgery Epileptic Center,Fuzhou General Hospital of Nanjing Military Command from Sep.2011 to Sep.2012.Clinical manifestation,preoperative evaluation,postoperative follow-up of the children were analyzed.Results After first epilepsy resection surgery,3 patients had little decrease in seizure rate(Engel class Ⅳ),the other one had seizure freedom (Engel class Ⅰ),but got recurrence after 2 years.Four cases were all underwent extended resection reoperation du-ring the study period.Types resection included temporoparietooccipital (3/4 cases) and frontal (1/4 cases),mean follow-up 11.25 months.One of the 4 patients had seizure freedom (Engel class Ⅰ),and 3 cases of the 4 patients had seizure reduction (Engel class Ⅱ) at last follow-up,in addition,none of them had significant or unacceptable complication.Conclusions Patients with recurrent drug resistant epilepsy after an initial resection surgery can regain seizure freedom outcome when they underwent repeat resection surgery after comprehensive reevaluation.Predictors with likelihood of seizure freedom after reoperation are:(1) retained medial temporal structures or relevant magnetic resonance imaging structural lesion;(2) original surgery suboptimal; (3) preceding evaluation suggests solitary identified focus;(4) semiology relate to preoperative seizures.
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Objective To analysis newborn stage and long-term physiological and neuropsychological development in children born after assisted reproductive technology(ART),and to evaluate the safety of ART.Methods Eighty-four 6-month-old to 6-year-old children born after ART performed from January 1st,2006 to June 30th,2011 in Reproduction Center of Fuzhou General Hospital were taken as ART group; and 84 matched children born after spontaneous conception were as control group.The physiological and neuropsychological states of these children in their newborn stage and 6-month-old to 6-year-old duration were compared with Chi-square or t test.Results There was no statistical difference in childbearing age of mothers,the prevalence of gestational diabetes mellitus and hypcrtensive disorder complicating pregnancy,delivery mode,living environment,parents' education level,newborn birth length,birth weight,the rate of premature birth,low birth weight,asphyxia and hospitalized to neonatal intensive care unit between two groups (P＞0.05).In ART group,the incidence of growth retardation and abnormal social life skills was 6.0 ％ (5/84) and 1.2 ％ (1/84),and no statistical difference were found comparing with control guoup [4.8％(4/84) and 1.2％(1/84),x2 =0.12 and 0.00,P＞0.05],neither the developmental quotient (95.9±6.1 vs 94.8±5.1,t=1.25,P=0.21).Twins had higher rates of preterm birth [41.8％ (33/79) vs 10.1％(9/89),x2 =22.37,OR=6.38,95％CI:2.81-14.50,P=0.00],low birth weight [51.9％(41/79) vs 6.7％(6/89),x2=42.35,OR=14.93,95％ CI:5.84-38.16,P=0.00],asphyxia [10.1 ％ (8/79) vs 1.1 ％(1/89),x2 =6.69,OR=9.92,95％ CI:1.21～81.15,P=0.01],hospitalized to neonatal intensive care unit [36.7 ％ (29/79) vs 14.6 ％ (13/89),x2 =10.90,OR =3.39,95％CI:1.61-7.14,P=0.00] and growth retardation [11.4％(9/79) vs 0.0％(0/89),x2=10.71,RR=0.11,P=0.00] than singleton.Conclusions ART has no negative effects on children's physical and neuropsychological development.It could increase the incidence of twins,so that it might increase the incidences of preterm labor and low birth weight,which might affect the long-term physical and neuropsychological development of the offspring.
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Objective To study the toxicity of topiramate (TPM), an antiepileptic drug, on embryonic development in rats. Methods Fifty one female pregnant rats were divided into five groups. TPM 40 mg/kg, TPM 80 mg/kg and TPM 40 mg/kg+ valproate acid( VPA) 300 mg/kg were given to group A,B and C respectively by gavage on day 6～15 through gestation. The negative control group(D) were administered with distilled water and the positive control group(E) were treated with cyclophosphomide (CP) (10 mg/kg on day 11, ip). All animals were sacrificed on day 20. The survival, dead and absorbed fetus was calculated. The parameters of embryonic and fetal development were analyzed and external abnormality was examined. Results Maternal body weight gain in group A,B and C [(89.6?16.5) g, (74.8?10.7) g, (91.5?20.3) g] was significantly lower than that of group D [(109.5?14.2) g ( P