Comprehensive Epilepsy Center, Columbia University Medical Center, New York City, New York, USA.
Epilepsia. 2010 Jan;51(1):43-7. doi: 10.1111/j.1528-1167.2009.02170.x. Epub 2009 Jun 10.
To investigate and compare injury rates, associated risk factors, circumstances, and medical record documentation in patients with pharmacoresistant temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE).
The study cohort consisted of fifty-two consecutive adults with treatment-resistant epilepsy and seizure classification confirmed by video-electrocardiography (EEG) (28 with TLE and 24 with ETLE) who consented to participate. All subjects had their seizures classified with prior video-EEG monitoring, were followed in a tertiary-care center in northwest New York City, and received a semistructured phone interview regarding injuries experienced since being diagnosed with epilepsy.
Injuries were reported in 16 (57%) of the patients with TLE and 4 (17%) of the patients with ETLE (p = 0.004 after controlling for duration of epilepsy and seizure burden); 83% of all injuries were designated by patients as seizure-related. Most injuries (22 of 41; 54%) were classified as moderate or greater in severity. In addition, one motor vehicle accident (MVA) was reported in the TLE group and one episode of sudden unexpected death (SUDEP) was identified in the ETLE group. More than half (55%) of the injuries were not documented as seizure-related in medical records.
A substantial number of potentially serious injuries are not documented as seizure related, even in a tertiary-care setting. Patients with pharmacoresistant TLE may be at higher risk for experiencing an injury than patients with pharmacoresistant ETLE.
调查和比较药物难治性颞叶癫痫（TLE）和颞外癫痫（ETLE）患者的损伤率、相关危险因素、情况和病历记录。
研究队列包括 52 名连续的成年药物难治性癫痫患者，这些患者的癫痫发作分类通过视频-心电图（EEG）（28 名 TLE 患者和 24 名 ETLE 患者）得到确认，他们同意参与研究。所有患者的癫痫发作都在纽约市西北部的一家三级护理中心进行了视频-EEG 监测，并接受了关于确诊癫痫后受伤经历的半结构化电话采访。
16 名（57%）TLE 患者和 4 名（17%）ETLE 患者报告了损伤（在控制癫痫持续时间和癫痫发作负担后，p=0.004）；所有损伤中有 83%被患者指定为与癫痫发作有关。大多数损伤（41 例中的 22 例；54%）被归类为中度或更严重。此外，TLE 组报告了一起机动车事故（MVA），ETLE 组报告了一起突发性意外死亡（SUDEP）。超过一半（55%）的损伤在病历中未被记录为与癫痫发作有关。
即使在三级护理环境中，也有相当数量的潜在严重损伤未被记录为与癫痫发作有关。药物难治性 TLE 患者比药物难治性 ETLE 患者更有可能经历损伤。
