Department of Neurology, Taipei Veterans General Hospital, and National Yang-Ming University, Taiwan.
Epilepsy Behav. 2010 Nov;19(3):436-40. doi: 10.1016/j.yebeh.2010.08.013. Epub 2010 Sep 17.
To investigate the relationship of interictal epileptiform discharges (IEDs) within 1 month of anterior temporal lobectomy (ATL) to seizure outcome, we reviewed data for 202 (107 left ATL, 95 right ATL) patients who had undergone ATL for mesial temporal epilepsy. Postoperative EEGs within 30 days and other preoperative variables were analyzed to examine the significant factors that determine freedom from disabling seizures. IEDs were noted in 29 (22.3%) of the 130 patients without seizures for 2 years after ATL compared with 31 (43.1%) of the 72 patients with recurrent seizures (P = 0.002). Postoperative IEDs remained an independent predictive factor for seizure outcome by logistic regression (adjusted OR = 2.38, 95% CI = 1.18-4.81, P = 0.016, 2 years postoperatively; adjusted OR = 2.22, 95% CI = 1.03-4.82, P = 0.043, 5 years postoperatively) and Cox hazard regression analysis (adjusted HR = 1.76, 95% CI = 1.18-2.62, P = 0.006) after controlling for other predicting factors (unilateral hippocampal atrophy, history of febrile seizures, and IQ scores). In this study, IEDs on the EEG obtained soon after surgery were associated with postoperative seizure recurrence. These results can be used in the assessment of risk of seizure recurrence after ATL.
为了研究手术前 1 个月内的间发性癫痫样放电 (IEDs)与手术结果的关系，我们回顾了 202 例（107 例左侧前颞叶切除术，95 例右侧前颞叶切除术）接受前颞叶切除术治疗内侧颞叶癫痫的患者数据。分析了术后 30 天内的脑电图和其他术前变量，以检查确定无致残性发作的显著因素。与无复发性癫痫发作的 130 例患者中的 29 例（22.3%）相比，72 例复发性癫痫发作的患者中有 31 例（43.1%）术后有 IED（P = 0.002）。术后 IEDs 仍然是手术结果的独立预测因素，通过逻辑回归（调整后的 OR = 2.38，95%CI = 1.18-4.81，P = 0.016，术后 2 年；调整后的 OR = 2.22，95%CI = 1.03-4.82，P = 0.043，术后 5 年）和 Cox 风险回归分析（调整后的 HR = 1.76，95%CI = 1.18-2.62，P = 0.006），控制了其他预测因素（单侧海马萎缩、热性惊厥史和智商分数）。在这项研究中，手术后获得的脑电图上的 IEDs 与术后癫痫发作复发有关。这些结果可用于评估前颞叶切除术后癫痫复发的风险。
