Vermeulen Lynn, van Loon Johannes, Theys Tom, Goffin Jan, Porke Kathleen, Van Laere Koen, Goffin Karolien, Vandenbulcke Mathieu, Thijs Vincent, Van Paesschen Wim
Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.
Acta Neurol Belg. 2016 Sep;116(3):271-8. doi: 10.1007/s13760-016-0605-6. Epub 2016 Feb 5.
We performed a retrospective outcome study of 199 patients who underwent resective epilepsy surgery from 1998 to 2012 and had a minimum of one-year follow-up at the University Hospitals Leuven. Our aim was to assess seizure outcome, prognostic factors for seizure outcome and complication rate. Good seizure outcome after surgery was 38 % at 5 years and 34 % at 10 years follow-up. Good seizure outcome over the previous year at last follow-up, however, was 77 %, which could be explained by the 'running-down phenomenon', i.e. seizure freedom after initial recurrent epilepsy in 32 % of the patients, mainly after temporal lobe surgery. Good seizure outcome for at least 1 year at the last visit was 82 % for temporal and 62 % for extra-temporal lobe interventions. Other variables predictive of a good seizure outcome were not identified. Permanent complications of epilepsy surgery were observed in 31 %. The most important were word finding difficulties (22 %), depression (18 %) and memory deficits (12 %). In conclusion, epilepsy surgery is an excellent treatment option for selected patients, with a good seizure outcome in around 80 % of patients and complications in about 30 %.
我们对199例于1998年至2012年间在鲁汶大学医院接受切除性癫痫手术且至少随访一年的患者进行了一项回顾性结局研究。我们的目的是评估癫痫发作结局、癫痫发作结局的预后因素以及并发症发生率。术后5年癫痫发作结局良好的比例为38%，10年随访时为34%。然而，在最后一次随访时，前一年癫痫发作结局良好的比例为77%，这可以用“衰退现象”来解释，即32%的患者在最初复发性癫痫发作后实现了癫痫发作自由，主要是在颞叶手术后。最后一次就诊时至少1年癫痫发作结局良好的比例，颞叶手术为82%，颞叶外手术为62%。未发现其他预测癫痫发作结局良好的变量。31%的患者出现了癫痫手术的永久性并发症。最重要的是找词困难（22%）、抑郁（18%）和记忆缺陷（12%）。总之，癫痫手术对于选定的患者是一种极佳的治疗选择，约80%的患者癫痫发作结局良好，约30%的患者出现并发症。
