视频脑电图记录的癫痫发作次数与难治性内侧颞叶癫痫手术结果的关系。
Relationship of number of seizures recorded on video-EEG to surgical outcome in refractory medial temporal lobe epilepsy.
作者信息
Sainju Rup Kamal, Wolf Bethany Jacobs, Bonilha Leonardo, Martz Gabriel
机构信息
Division of Neurology, Department of Neurosciences, Medical University of South Carolina (MUSC), Charleston, SC 29425, USA.
出版信息
Arq Neuropsiquiatr. 2012 Sep;70(9):694-9. doi: 10.1590/s0004-282x2012000900009.
INTRODUCTION
Surgical planning for refractory medial temporal lobe epilepsy (rMTLE) relies on seizure localization by ictal electroencephalography (EEG). Multiple factors impact the number of seizures recorded. We evaluated whether seizure freedom correlated to the number of seizures recorded, and the related factors.
METHODS
We collected data for 32 patients with rMTLE who underwent anterior temporal lobectomy. Primary analysis evaluated number of seizures captured as a predictor of surgical outcome. Subsequent analyses explored factors that may seizure number.
RESULTS
Number of seizures recorded did not predict seizure freedom. More seizures were recorded with more days of seizure occurrence (p<0.001), seizure clusters (p≤0.011) and poorly localized seizures (PLSz) (p=0.004). Regression modeling showed a trend for subjects with fewer recorded poorly localized seizures to have better surgical outcome (p=0.052).
CONCLUSIONS
Total number of recorded seizures does not predict surgical outcome. Patients with more PLSz may have worse outcome.
引言
难治性内侧颞叶癫痫（rMTLE）的手术规划依赖于发作期脑电图（EEG）进行癫痫发作定位。多种因素会影响记录到的癫痫发作次数。我们评估了癫痫发作缓解与记录到的癫痫发作次数以及相关因素之间是否存在关联。
方法
我们收集了32例行前颞叶切除术的rMTLE患者的数据。初步分析将记录到的癫痫发作次数作为手术结果的预测指标进行评估。后续分析探讨了可能影响癫痫发作次数的因素。
结果
记录到的癫痫发作次数并不能预测癫痫发作缓解情况。癫痫发作天数越多（p<0.001）、癫痫发作簇（p≤0.011）以及定位不佳的癫痫发作（PLSz）（p=0.004）时，记录到的癫痫发作次数越多。回归模型显示，记录到的定位不佳癫痫发作次数较少的受试者手术结果有更好的趋势（p=0.052）。
结论
记录到的癫痫发作总数不能预测手术结果。定位不佳癫痫发作次数较多的患者可能预后较差。
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