Sun Yuqiang, Wang Xiaofeng, Che Ningwei, Qin Huamin, Liu Shuping, Wu Xinling, Wei Minghai, Cheng Huakun, Yin Jian
Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
Department of Neurosurgery, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China.
Exp Ther Med. 2017 May;13(5):2225-2234. doi: 10.3892/etm.2017.4315. Epub 2017 Apr 6.
The aim of the present study was to investigate the effects of surgical intervention of focal cortical dysplasia (FCD) IIa on the outcome of epilepsy, and to evaluate the prognostic factors of seizure freedom. Patient data from epilepsy surgeries were retrospectively reviewed at the Second Affiliated Hospital of Dalian Medical University between 2007 and 2015. A total of 110 patients with a definite pathological diagnosis of FCD IIa were included. Moreover, the clinical characteristics, seizure outcome and quality of life in adults with FCD IIa were evaluated. The Engel seizure outcome achievements were class I in 72, class II in 20, class III in 11 and class IV in 7 patients. In addition, the Engel seizure outcome was relevant with the resection range of the lesions (P=0.028). The assessments of electrocorticography (ECoG) patterns and magnetic resonance imaging (MRI) are relevant to determining the extent of the resection, which may influence the surgery outcome (P=0.001 and P=0.023). Using multivariate regression analyses, the extent of resection, seizure frequency, preoperative ECoG and location of resection were the most important risk factors for seizure recurrence. The results of quality of life in epilepsy-10 scoring revealed that the quality of life improved significantly following surgery (P<0.01). Moreover, surgical intervention, EcoG, MRI positioning and complete resection helped to have improved seizure control, relief of anxiety and quality of life. All these observations strongly recommend an early consideration of epilepsy surgery in FCD IIa patients.
本研究的目的是探讨局灶性皮质发育不良（FCD）IIa型的手术干预对癫痫预后的影响，并评估无癫痫发作的预后因素。回顾性分析了2007年至2015年大连医科大学附属第二医院癫痫手术患者的数据。共纳入110例经病理确诊为FCD IIa型的患者。此外，还评估了FCD IIa型成年患者的临床特征、癫痫发作结局和生活质量。Engel癫痫发作结局分级为I级的有72例，II级的有20例，III级的有11例，IV级的有7例。此外，Engel癫痫发作结局与病变切除范围相关（P=0.028）。皮质脑电图（ECoG）模式和磁共振成像（MRI）评估与确定切除范围相关，这可能影响手术结果（P=0.001和P=0.023）。通过多因素回归分析，切除范围、癫痫发作频率、术前ECoG和切除部位是癫痫复发的最重要危险因素。癫痫生活质量-10评分结果显示，术后生活质量显著改善（P<0.01）。此外，手术干预、EcoG、MRI定位和完全切除有助于改善癫痫控制、缓解焦虑和提高生活质量。所有这些观察结果强烈建议对FCD IIa型患者尽早考虑癫痫手术。
