Jin Yichao, Zhao Changyi, Zhang Shilei, Zhang Xiaohua, Qiu Yongming, Jiang Jiyao
Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
Clin Neurol Neurosurg. 2014 Apr;119:59-63. doi: 10.1016/j.clineuro.2014.01.013. Epub 2014 Jan 25.
The objective of this study was to retrospectively review the postoperative seizure outcome in patients with short duration of epilepsy associated with cavernous malformations and analyze the effect of surgical methods on seizure outcome in such population.
36 patients with short duration of epilepsy (shorter than 12 months) associated with cavernous malformations in temporal or frontal lobe underwent microsurgical resection. The patients were retrospectively divided into two groups: Group A (21 patients) with complete removal of hemosiderin rim and Group B (15 patients) with partial removal of hemosiderin rim. Clinical follow-up was achieved with telephone correspondence or outpatient assessment. The seizure outcome was based on Engel's classification.
After a mean follow-up period of 18 months, 77.8% of the patients (28/36) were classified into Engel class I, including 19 patients (90.5%) in the complete removal of hemosiderin rim group (Group A) and 9 patients (60%) in the partial removal of hemosiderin rim group (Group B). Seizure outcome was significantly better in Group A. There was no mortality and all the postoperative neurological deficits were recovered at the time of follow-up.
The analysis of the seizure outcome demonstrate patients with short duration of epilepsy associated with cavernous malformations could benefit greatly from complete resection of hemosiderin rim and cavernous malformations.
本研究的目的是回顾性分析癫痫发作病程较短的海绵状血管畸形患者的术后癫痫发作结局，并分析手术方法对此类患者癫痫发作结局的影响。
36例癫痫发作病程较短（短于12个月）且颞叶或额叶有海绵状血管畸形的患者接受了显微手术切除。患者被回顾性分为两组：A组（21例）完全切除含铁血黄素环，B组（15例）部分切除含铁血黄素环。通过电话随访或门诊评估进行临床随访。癫痫发作结局根据恩格尔分类法判定。
平均随访18个月后，77.8%的患者（28/36）被归类为恩格尔I级，其中完全切除含铁血黄素环组（A组）有19例患者（90.5%），部分切除含铁血黄素环组（B组）有9例患者（60%）。A组的癫痫发作结局明显更好。无死亡病例，所有术后神经功能缺损在随访时均已恢复。
对癫痫发作结局的分析表明，癫痫发作病程较短的海绵状血管畸形患者可从含铁血黄素环和海绵状血管畸形的完全切除中大大获益。
