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脊髓脊膜膨出患者癫痫发作的频率、预测因素和结局:单中心回顾性队列研究。

Frequency, Predictors, and Outcome of Seizures in Patients With Myelomeningocele: Single-Center Retrospective Cohort Study.

机构信息

5170University of Louisville, Louisville, KY, USA.

12298State University of New York, Downstate Medical Center, Brooklyn, NY, USA.

出版信息

J Child Neurol. 2022 Jan;37(1):80-88. doi: 10.1177/08830738211053132. Epub 2021 Nov 24.

Abstract

To determine the frequency, predictors, and outcomes of seizures in patients with myelomeningocele, we retrospectively analyzed the data from patients with myelomeningocele followed longitudinally at a single center from 1975 to 2013. We identified a total of 122 patients (61% female). The mean follow-up duration was 11.1 years (minimum-maximum = 0-34.5 years, SD = 8.8, median = 9.1 years). A total of 108 (88.5%) patients had hydrocephalus, and 98 (90.7%) of those patients required a ventriculoperitoneal shunt procedure. Twenty-four (19.7%) patients manifested with seizures, 23 of whom had hydrocephalus. The average age of seizure onset was 4.8 years (median 2 years of age). Falx dysgenesis ( = .004), lumbar myelomeningocele ( = .007), and cortical atrophy ( = .028) were significantly associated with epileptic seizure development. The average seizure-free period at the last follow-up in patients with a history of myelomeningocele and seizures was 8.1 years. We conclude that myelomeningocele patients with seizures have an overall good prognosis with considerable long-term seizure freedom.

摘要

为了确定脑脊膜膨出患者癫痫发作的频率、预测因素和结局,我们回顾性分析了 1975 年至 2013 年在单一中心接受长期随访的脑脊膜膨出患者的数据。我们共确定了 122 例患者(61%为女性)。平均随访时间为 11.1 年(最小-最大=0-34.5 年,SD=8.8,中位数=9.1 年)。共有 108 例(88.5%)患者患有脑积水,其中 98 例(90.7%)需要行脑室-腹腔分流术。24 例(19.7%)患者出现癫痫发作,其中 23 例有脑积水。癫痫发作的平均年龄为 4.8 岁(中位数 2 岁)。镰状突发育不良(=0.004)、腰骶部脑脊膜膨出(=0.007)和皮质萎缩(=0.028)与癫痫发作的发生显著相关。在有脑脊膜膨出和癫痫病史的患者中,最后一次随访时无癫痫发作的平均时间为 8.1 年。我们得出结论,有癫痫发作的脑脊膜膨出患者总体预后良好,长期无癫痫发作的比例相当高。

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