Alsumaili Mohammad, Alkhateeb Mashael, Khoja Abeer, Alkhaja Mohammed, Alsulami Ashwaq, Alqadi Khalid, Baz Salah, Abalkhail Tariq, Babtain Fawzi, Althubaiti Ibrahim, Abu-Ata Mahmoud, Alotaibi Faisal
Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, Saudi Arabia; Pediatric Department, Armed Forces Hospital, Khamis Mushayt, Saudi Arabia.
Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, Saudi Arabia.
Epilepsy Res. 2021 Jul;173:106620. doi: 10.1016/j.eplepsyres.2021.106620. Epub 2021 Mar 23.
To analyze the surgical outcome in non-lesional intractable focal epilepsies in our center and to find possible predictors for better outcome.
This is a retrospective study for 40 adult patients with intractable focal epilepsy following at KFSHRC-Riyadh, who underwent presurgical evaluation followed by resective surgery and continued follow up for a minimum of 2 years. The surgery outcome was evaluated based on the type of surgical procedure and histopathology results.
Out of all 40 patients studied, seizure freedom was achieved in 19 (47.5 %) and 17 (42.5 %) patients at the first and second year respectively in all non-lesional cases. Seizure freedom in non-lesional temporal lobe surgery was achieved in 10 (45 %) of patients at 2 years, 5 (38 %) in non-lesional frontal lobe patients at 2 years and 8 (44 %), 7 (38 %) for all extratemporal at 1 and 2 years respectively. Good prognosis was seen in patients with localized positron emission tomography (PET), had no aura and had a clear ictal onset either on scalp electroencephalogram (EEG) or subdural invasive electroencephalogram.
The best surgical outcome is achievable in patients with non-lesional focal epilepsy. This study highlights the prognostic value of the PET scan and ictal scalp/subdural invasive EEG.
分析本中心非病灶性顽固性局灶性癫痫的手术结果，并寻找可能的预后良好预测因素。
这是一项对40例在利雅得国王费萨尔专科医院和研究中心接受治疗的成年顽固性局灶性癫痫患者的回顾性研究，这些患者接受了术前评估，随后进行了切除性手术，并持续随访至少2年。根据手术方式和组织病理学结果评估手术效果。
在所有40例研究患者中，所有非病灶性病例分别在第一年和第二年有19例（47.5%）和17例（42.5%）实现无癫痫发作。非病灶性颞叶手术患者在2年时有10例（45%）实现无癫痫发作，非病灶性额叶患者在2年时有5例（38%）实现无癫痫发作，所有颞叶外手术患者在1年和2年时分别有8例（44%）和7例（38%）实现无癫痫发作。正电子发射断层扫描（PET）定位、无先兆且头皮脑电图（EEG）或硬膜下侵入性脑电图有明确发作起始的患者预后良好。
非病灶性局灶性癫痫患者可获得最佳手术效果。本研究强调了PET扫描以及发作期头皮/硬膜下侵入性EEG的预后价值。
