Tanriverdi Taner, Poulin Nicole, Olivier Andre
Department of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
Seizure. 2008 Jun;17(4):339-49. doi: 10.1016/j.seizure.2007.11.003. Epub 2008 Feb 20.
It has been suggested that aim of the temporal lobe epilepsy surgery is twofold: first is to decrease seizure frequency and second is to improve quality of life without causing intolerable complications. The aim of this prospective, longitudinal clinical study is to report outcomes with respect to seizure, medication, employment and quality of life in short- and long-term follow-ups after resective temporal lobe epilepsy surgery. Consecutively 63 patients who underwent resective temporal lobe epilepsy surgery between 1993 and 1994 were enrolled. Outcomes at 6 months, 2 and 12 years were evaluated and compared with pre-operative status. The mean follow-up of this study was 12.3+/-0.6 years. Results showed that rates of seizure freedom were 82.5, 76.2, and 70.8% at 6 months, 2 and 12 years, respectively. Significant reduction in antiepileptic drug dose at long-term follow-up was found when compared to baseline. Patients after surgery had net gain of employment and improved quality of life was seen in all seizure outcome groups after surgery. Seizure-free patients showed better quality of life than those who continued to have seizure. Our results suggest that surgery leads to improvement in both seizure outcome and quality of life. Even years after the surgery, patients are still working, have reduced their medication load and have nearly normal life.
有人提出，颞叶癫痫手术的目标有两个：一是降低癫痫发作频率，二是提高生活质量，同时不引起无法忍受的并发症。这项前瞻性纵向临床研究的目的是报告切除性颞叶癫痫手术后短期和长期随访中癫痫发作、药物治疗、就业和生活质量方面的结果。连续纳入了1993年至1994年间接受切除性颞叶癫痫手术的63例患者。评估了6个月、2年和12年时的结果，并与术前状态进行比较。本研究的平均随访时间为12.3±0.6年。结果显示，6个月、2年和12年时的无癫痫发作率分别为82.5%、76.2%和70.8%。与基线相比，长期随访时抗癫痫药物剂量显著减少。术后患者就业有净增加，且术后所有癫痫发作结果组的生活质量均有所改善。无癫痫发作的患者比仍有癫痫发作的患者生活质量更好。我们的结果表明，手术可改善癫痫发作结果和生活质量。即使在手术后数年，患者仍在工作，减少了药物负担，生活几乎正常。
