中华医学杂志（英文版）2011，Vol.124Issue(24)：4166-4171,6.DOI:10.3760/cma.j.issn.0366-6999.2011.24.009
Predictors of outcome in the surgical treatment for epilepsy
Predictors of outcome in the surgical treatment for epilepsy
摘要
Abstract
Background Knowledge about factors influencing the prognosis of resective epilepsy surgery can be used to identify which patients are most suitable for surgical treatment.The aim of this study was to identify preoperative prognostic factors associated with the chance of achieving long-term seizure freedom.Methods We retrospectively reviewed seizure outcomes and clinical,electroencephalography (EEG),magnetic resonance imaging (MRI),histopathology,and surgical variables from 99 epilepsy surgery patients with at least one year of postoperative follow-up.Seizure outcomes were categorized based on the modified classification by the International League Against Epilepsy.Results We found that the seizure-free rate was 27.9％ after one year,and that it stabilized at about 20.0％ between two and six years after surgery.Univariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis,MRI with visible focal lesions concordant with EEG,and regional ictal EEG and electrocorticography patterns were associated with a favorable surgical outcome.On the other hand,seizure recurrence within six months,incomplete focus resection,and surgical complications were associated with a poor outcome.Multivariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis and MRI with visible focal lesions were independent presurgical predictors of a favorable outcome (P ＜0.01).Seizure recurrence within six months was the only significant independent predictor associated with a poor outcome (P ＜0.01).Conclusion Hippocampal sclerosis and abnormal MRI findings are strongly associated with a favorable surgical outcome,whereas seizure recurrence within six months is associated with a poor outcome.关键词
epilepsy surgery/seizure outcome/focal cortical dysplasia/magnetic resonance imaging/electroencephalographyKey words
epilepsy surgery/seizure outcome/focal cortical dysplasia/magnetic resonance imaging/electroencephalography引用本文复制引用
YANG Xiao-lan,LU Qin-chi,XU Ji-wen,WANG Gui-song,LIU Qiang..Predictors of outcome in the surgical treatment for epilepsy[J].中华医学杂志（英文版）,2011,124(24):4166-4171,6.基金项目
This study was supported by grants from Shanghai Jiao Tong University Med-X Fund (No.YG08PET2D05) and Shanghai Science & Technology Committee Fund (No.llZR 1421800). （No.YG08PET2D05）
