Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Epilepsia. 2021 May;62(5):1085-1091. doi: 10.1111/epi.16872. Epub 2021 Mar 13.
This study was undertaken to identify clinical factors associated with seizure freedom after magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) in temporal lobe epilepsy patients with unilateral mesial temporal sclerosis (MTS).
We identified 56 patients with magnetic resonance imaging-defined MTS who underwent MRgLiTT with at least 1 year of follow-up. Primary outcome was seizure freedom at 1 year. We examined the association of seizure freedom and the following clinical factors: age at surgery, gender, history of febrile seizures, history of focal to bilateral tonic-clonic seizures, duration of epilepsy at the time of surgery, frequency of interictal epileptiform discharges (IEDs), seizure frequency, and presence of bilateral IEDs.
Thirty-five (62.5%) patients were seizure-free at 1 year. The presence of bilateral IEDs and age at surgery were associated with 1-year seizure freedom after MRgLiTT. The presence of bilateral IEDS was associated with lower odds of seizure freedom (odds ratio [OR] = .05, 95% confidence interval [CI] = .01-.46, p = .008), whereas increasing age at surgery was associated with increased odds of seizure freedom (OR = 1.10, 95% CI = 1.03-1.19, p = .009).
This study demonstrates associations between presence of bilateral IEDs and age at surgery and seizure freedom at 1 year after MRgLiTT.
本研究旨在确定磁共振引导激光间质热疗（MRgLiTT）治疗单侧内侧颞叶硬化（MTS）颞叶癫痫患者无癫痫发作的相关临床因素。
我们确定了 56 例经磁共振成像定义的 MTS 患者，这些患者接受了 MRgLiTT 治疗，且随访时间至少为 1 年。主要结果为 1 年后无癫痫发作。我们检查了无癫痫发作与以下临床因素的相关性：手术时的年龄、性别、热性惊厥史、局灶性到双侧强直阵挛性癫痫史、手术时癫痫的持续时间、间发性癫痫样放电（IED）的频率、癫痫发作频率以及双侧 IED 的存在。
35 例（62.5%）患者在 1 年后无癫痫发作。双侧 IED 的存在和手术时的年龄与 MRgLiTT 后 1 年的无癫痫发作有关。双侧 IED 的存在与无癫痫发作的可能性较低相关（比值比[OR] =.05，95%置信区间[CI] =.01-.46，p =.008），而手术时年龄的增加与无癫痫发作的可能性增加相关（OR = 1.10，95% CI = 1.03-1.19，p =.009）。
本研究表明双侧 IED 的存在与手术时的年龄与 MRgLiTT 后 1 年的无癫痫发作之间存在相关性。
