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新诊断为部分性发作的患者,其脑内仅有单个囊尾蚴肉芽肿或神经影像学正常,其癫痫复发风险。

Risk of seizure recurrence in patients of new-onset partial seizure having a solitary cysticercus granuloma of brain or normal neuroimaging.

机构信息

Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Uttar Pradesh, Lucknow, India.

出版信息

J Neurol Sci. 2011 Feb 15;301(1-2):21-6. doi: 10.1016/j.jns.2010.11.013. Epub 2010 Dec 9.

Abstract

BACKGROUND

Solitary cysticercus granuloma - a benign form of parenchymal neurocysticercosis - is considered as the most common cause of partial seizures. This study comparatively evaluated the seizure-related prognosis in patients with new-onset seizure having solitary cysticercus granuloma and in patients with normal neuroimaging. We also assessed the factors of seizure recurrence.

MATERIAL AND METHOD

Seventy-four patients of new-onset partial seizure with solitary cysticercus granuloma and 45 patients of new-onset partial seizure with normal neuroimaging were followed up for 6 months. A follow-up neuroimaging was carried out after 3 months.

RESULT

Thirteen patients (17.6%) in solitary cysticercus granuloma group and 15 patients (33.3%) in normal neuroimaging group had seizure recurrences (P = 0.049). In solitary cysticercus granuloma group, family history of seizure disorder (P = 0.004), headache (P = 0.029), and serial seizures (at onset) (P = 0.001) were significantly associated with the seizure recurrence. Granuloma remained unresolved in all patients. In patients with normal neuroimaging, abnormal EEG (P = 0.043), at inclusion, was only a significant factor of the seizure recurrence.

CONCLUSION

The patients with solitary cysticercus granuloma had favorable seizure-related prognosis when compared with patients having normal neuroimaging. Serial seizures and headache predicted seizure recurrence in patients with solitary cysticercus granuloma. The presence of electroencephalographic abnormality predicted seizure recurrence in patients with normal neuroimaging.

摘要

背景

单纯性囊尾蚴肉芽肿——实质型脑囊虫病的良性形式——被认为是引起部分性癫痫发作的最常见原因。本研究比较了新诊断为单纯性囊尾蚴肉芽肿性癫痫发作患者和影像学正常患者的癫痫相关预后。我们还评估了癫痫复发的相关因素。

材料与方法

对 74 例新诊断为单纯性囊尾蚴肉芽肿性局灶性癫痫发作患者和 45 例影像学正常的新诊断为局灶性癫痫发作患者进行了 6 个月的随访。在 3 个月后进行了随访影像学检查。

结果

单纯性囊尾蚴肉芽肿组中有 13 例(17.6%)患者和影像学正常组中有 15 例(33.3%)患者出现癫痫复发(P = 0.049)。在单纯性囊尾蚴肉芽肿组中,癫痫发作家族史(P = 0.004)、头痛(P = 0.029)和首发时的连续癫痫发作(P = 0.001)与癫痫复发显著相关。所有患者的肉芽肿均未消退。在影像学正常的患者中,脑电图异常(P = 0.043)在纳入时是癫痫复发的唯一显著因素。

结论

与影像学正常的患者相比,单纯性囊尾蚴肉芽肿患者的癫痫相关预后较好。连续癫痫发作和头痛可预测单纯性囊尾蚴肉芽肿患者的癫痫复发。存在脑电图异常可预测影像学正常患者的癫痫复发。

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