临床神经病学杂志2011，Vol.24Issue(2)：88-91,4.
脑磁图引导下伽玛刀治疗难治性癫(癎)的疗效及其影响因素研究
Investigation of efficacy and its influence factors of magnetoencephalography guided gamma knife radiosurgery on treating refractory epilepsy
摘要
Abstract
Objective To explore the efficacy and its influence factors of magnetoencephalography (MEG) guided gamma knife radiosurgery on treating refractory epilepsy (RE). Methods The clinical data of 40 RE patients were collected, and the patients were treated with gamma knife radiosurgery after the localization of epileptogenic focus guided by MEG and EEG. The condition of seizures was observed after the treatment, and followed up for 2-4 years. Engel's classification was used to assess its efficacy. The patients who reached Engel class Ⅰ and Ⅱ were assigned to the good outcome group, class Ⅳ to the poor outcome group, and class Ⅲ were not included. The clinical data of the patients were compared between good outcome group and poor outcome group. The influence factors of therapeutic effects of gamma knife were analyzed by multivariate Logistic regression. Results At the end of the follow up, 19 cases (47.5％) reached Engel class Ⅰ , 7 cases ( 17.5％ ) reached Engel class Ⅱ , 5 cases ( 12.5％ ) reached Engel class Ⅲ, 9 cases (22.5％) reached Engel class Ⅳ. The effective rate was 65.0％.Only one patient suffered a brief headache caused by brain edema after treatment. The seizure frequency and the rate of mental retardation in poor outcome group was significantly higher, and the rate of temporal epilepsy was significantly lower than those in good outcome group ( P ＜ 0. 05 - 0. 005 ). The multiple Logistic regression showed that mental retardation was the influence factor of poor outcome of gamma knife radiosurgery treatment ( OR = 1.16,95％ CI: O. 49 - 1.89, P = 0. 025 ), while the temporal epilepsy was the influence factor of good outcome ( OR = O.74,95％ CI: O. 21 -2.55, P= O. 021 ). Conclusions Gamma knife radiosurgery guided by MEG is evidently effective therapy for Re patients. Mental retardation is an independent risk factor, while temporal epilepsy is a protective factor for the gamma knife radiosurgery efficacy of RE patients.关键词
难治性癫(癎)/脑磁图/伽玛刀/疗效/影响因素Key words
refractory epilepsy/ magnetocncephalography/ gamma knife radiosurgery/ efficacy/ influence factors分类
医药卫生引用本文复制引用
杨露,狄晴,佘永传,吴婷,江炜炜,王凌玲..脑磁图引导下伽玛刀治疗难治性癫(癎)的疗效及其影响因素研究[J].临床神经病学杂志,2011,24(2):88-91,4.基金项目
南京市医学科技发展重大项目(2007-0211) （2007-0211）
