临床神经外科杂志2019，Vol.16Issue(4)：299-303,5.DOI:10.3969/j.issn.1672-7770.2019.04.005
海马硬化合并局灶性皮质发育不良致难治性颞叶癫痫手术预后的影响因素
Analysis on prognostic factors in surgery for refractory temporal lobe epilepsy induced by hippocampal sclerosis with focal cortical dysplasia
摘要
Abstract
To study the prognostic factors of surgical operation in patients with refractory temporal lobe epilepsy ( TLE) induced by dual pathology of hippocampal sclerosis ( HS) with focal cortical dysplasia (FCD).Methods The clinical data of 45 patients with refractory TLE induced by pathological proved dual pathology ( HS with FCD) were analyzed retrospectively.The postoperative follow-up ranged from 1 to 5years, according to the follow-up results.Engel classⅠ-Ⅱwere taken as the effective treatment group and Engel class Ⅲ-Ⅳ were taken as the ineffective treatment group.The binary logistic regression analysis was used to investigate the factors influencing the prognosis of surgery.Results 29 (29／45) patients were in the effective treatment group.Among them, 27 were Engel class Ⅰand 2 were Engel class Ⅱ.16(16／45) patients were in the ineffective treatment group.Among them, 9 were Engel class Ⅲand 7 were Engel class Ⅳ. Binary logistic regression analysis showed that histopathological subtypes were FCD Ⅲa or not ( χ2 ＝4.593, P ＝0.032, OR ＝6.098, 95% CI ＝1.167 -31.863 ) and complete resection of epileptogenic area or not (χ2 ＝9.477, P＝0.002, OR＝13.487, 95%CI＝2.574-70.679) were statistically significant.Onset age, preoperative seizure frequency , course of onset, age at operation, having a history of febrile seizure or not and positive or not on MRI were not statistically significant(P＞0.05).Conclusion The operative prognoses of the patients with TLE induced by dual pathology(HS with FCD) are associated with histopathological subtypes , complete resection of epileptogenic area.关键词
颞叶癫痫/海马硬化/局灶性皮质发育不良/手术/预后Key words
epilepsy/hippocampal sclerosis/focal cortical dysplasia/operation/prognosis分类
医药卫生引用本文复制引用
霍俊杰,朱海涛,杨露,徐宏浩,张锐..海马硬化合并局灶性皮质发育不良致难治性颞叶癫痫手术预后的影响因素[J].临床神经外科杂志,2019,16(4):299-303,5.基金项目
南京市医学科技发展专项资助一般课题(YKK17136) （YKK17136）
