烟雾病小儿患者血运重建术后癫痫复发的危险因素
Risk Factors for Epilepsy Recurrence after Revascularization in Pediatric Patients with Moyamoya Disease.
作者信息
Ma Yonggang, Zhao Meng, Zhang Qian, Liu Xingju, Zhang Dong, Wang Shuo, Zhang Yan, Li Maogui, Zhao Jizong
机构信息
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
出版信息
J Stroke Cerebrovasc Dis. 2018 Mar;27(3):740-746. doi: 10.1016/j.jstrokecerebrovasdis.2017.10.012. Epub 2017 Nov 8.
OBJECTIVE
We aimed to explore the risk factors of seizure recurrence and the optimal surgical procedure for epileptic pediatric patients with moyamoya disease (MMD).
METHODS
We reviewed 696 consecutive patients with MMD admitted to our hospital from 2009 to 2015. Pediatric patients with MMD who had seizures before revascularization were identified. We summarized the characteristics of seizures in pediatric patients with MMD and analyzed the predictive factors of recurrent seizure events.
RESULTS
We identified 28 pediatric patients with MMD who had seizures before revascularization. During follow-up (median 42 months), 7 patients (25.0%) experienced recurrent seizures. In the multivariate analysis, the duration of epilepsy was an independent predictor for postoperative seizure recurrences (odds ratio 3.84, 95% confidence interval 1.54-24.34; P = .035). The 2 common surgical modalities of MMD (direct and indirect bypass) had no significant difference in future seizure prevention in pediatric patients with MMD with epilepsy.
CONCLUSIONS
We identified the duration of epilepsy as an independent risk factor for recurrent seizure after revascularization in pediatric patients with MMD.
目的
我们旨在探讨烟雾病（MMD）癫痫患儿癫痫复发的危险因素及最佳手术方法。
方法
我们回顾了2009年至2015年连续收治于我院的696例MMD患者。确定了血管重建术前有癫痫发作的MMD患儿。我们总结了MMD患儿癫痫发作的特征，并分析了癫痫复发事件的预测因素。
结果
我们确定了28例血管重建术前有癫痫发作的MMD患儿。在随访期间（中位时间42个月），7例（25.0%）出现癫痫复发。多因素分析显示，癫痫发作持续时间是术后癫痫复发的独立预测因素（比值比3.84，95%置信区间1.54 - 24.34；P = 0.035）。MMD的两种常见手术方式（直接和间接搭桥）在预防MMD合并癫痫患儿未来癫痫发作方面无显著差异。
结论
我们确定癫痫发作持续时间是MMD患儿血管重建术后癫痫复发的独立危险因素。
Zotero 插件