He Xinghui, Liu Dingyang, Yang Zhuanyi, Zhang Junmei, Li Sushan, Yang Zhiquan
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
Front Neurol. 2020 Dec 10;11:580221. doi: 10.3389/fneur.2020.580221. eCollection 2020.
This study aims to evaluate the surgical outcomes and analyze the predictors of surgical outcomes in patients undergoing anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE) secondary to focal cortical dysplasia (FCD) type IIIa. Data on patients with drug-resistant TLE secondary to FCD type IIIa who had undergone ATL at Xiangya Hospital, Central South University from January 2014 to April 2018, were collected retrospectively. International League Against Epilepsy (ILAE) classification was used to evaluate postoperative seizure outcomes. Predictors of surgical outcomes were identified by using univariate and multivariate analyses. A total of 43 patients with drug-resistant TLE secondary to FCD type IIIa who had undergone ATL were included in this study. Twenty patients had right ATL, and 23 patients had left ATL. With a follow-up of 2-6 years, 76.7% (33 of 43) of patients were seizure-free. Univariate and multivariate analysis results indicated that lesions on the right side independently predict postoperative seizure freedom (OR, 0.08; 95% CI, 0.01-0.72; = 0.024). ATL is an effective therapy for patients with drug-resistant TLE secondary to FCD type IIIa. Patients with lesions on the right side are more likely to achieve postoperative seizure freedom.
本研究旨在评估接受前颞叶切除术（ATL）治疗继发于IIIa型局灶性皮质发育不良（FCD）的耐药性颞叶癫痫（TLE）患者的手术效果，并分析手术效果的预测因素。回顾性收集了2014年1月至2018年4月在中南大学湘雅医院接受ATL治疗的继发于IIIa型FCD的耐药性TLE患者的数据。采用国际抗癫痫联盟（ILAE）分类法评估术后癫痫发作结果。通过单因素和多因素分析确定手术效果的预测因素。本研究共纳入43例接受ATL治疗的继发于IIIa型FCD的耐药性TLE患者。20例患者接受了右侧ATL，23例患者接受了左侧ATL。随访2至6年，76.7%（43例中的33例）的患者无癫痫发作。单因素和多因素分析结果表明，右侧病变独立预测术后无癫痫发作（OR，0.08；95%CI，0.01 - 0.72；P = 0.024）。ATL是治疗继发于IIIa型FCD的耐药性TLE患者的有效方法。右侧有病变的患者术后更有可能实现无癫痫发作。
