Liu Jingjing, Xu Qinlan, Niu Hongchuan, Wang Rong, Ye Xun, Liu Xianzeng
Peking University International Hospital, Department of Neurology, Peking University, Beijing, China.
Boston Children's Hospital, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Harvard Medical School, Boston, USA.
Chin Neurosurg J. 2021 Feb 2;7(1):11. doi: 10.1186/s41016-020-00224-y.
Surgery is a conventional mature treatment for moyamoya disease (MMD). However, whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease.
The study was a systematic review and critical appraisal with a meta-analysis of cohort studies, both prospective and retrospective. Studies were identified by a computerized search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases. In a literature search, a total of 7 cohort studies were identified. The Istatistic was used to quantify heterogeneity. A fixed-effect model was used to synthesize the results. The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.
The pooled estimated postoperative incidence of seizure in pediatric patients with epileptic type moyamoya disease was 23.44%. The pooled estimated postoperative incidence of cerebral infarction in pediatric patients with epileptic type moyamoya disease was 9.12%. Low substantial heterogeneity and potential publication bias were present.
Evidence from this study suggests that the postoperative incidence of seizure and cerebral infarction is relatively low. Surgery is an effective and secure therapy for pediatric patients with epileptic type moyamoya disease.
手术是烟雾病（MMD）的一种传统成熟治疗方法。然而，手术是否也是癫痫型烟雾病的有效治疗方法，鲜有系统研究。本研究旨在总结癫痫型烟雾病患儿术后癫痫发作和脑梗死的合并发生率。
本研究是一项对队列研究（前瞻性和回顾性）进行系统评价和严格评估的荟萃分析。通过计算机检索PubMed、Embase、Web of Science、万方和知网数据库来识别研究。在文献检索中，共识别出7项队列研究。采用I统计量量化异质性。使用固定效应模型汇总结果。采用漏斗图不对称性的线性回归检验来估计潜在的发表偏倚。
癫痫型烟雾病患儿术后癫痫发作的合并估计发生率为23.44%。癫痫型烟雾病患儿术后脑梗死的合并估计发生率为9.12%。存在低度显著异质性和潜在发表偏倚。
本研究证据表明，癫痫发作和脑梗死的术后发生率相对较低。手术是治疗癫痫型烟雾病患儿的一种有效且安全的疗法。
