Li Yiming, Gao Jiayi, Ye Zi, Mu Jie
West China Clinical Medical School, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Front Neurol. 2023 Oct 20;14:1241763. doi: 10.3389/fneur.2023.1241763. eCollection 2023.
Magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) and stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-RFTC) are two effective, minimally invasive treatments for epilepsy with focal cortical dysplasia (FCD). The purpose of this study is to conduct a meta-analysis to evaluate and compare the efficacy and safety of these two therapies in epilepsy patients with FCD.
We searched PubMed, Embase, Cochrane, and other databases for articles published before March 2023. The primary objective was to compare the effectiveness and complications of MRgLiTT and SEEG-RFTC in epilepsy patients with FCD. The second objective was to determine which method provides a better prognosis for specific subgroup patients.
According to the inclusion and exclusion criteria, 18 studies were included, comprising 270 FCD patients including 37 patients from 6 MRgLiTT studies and 233 from 12 SEEG-RFTC studies. There were no significant differences between MRgLiTT and SEEG-RFTC groups in the seizure-freedom rate (59%, 95% CI 44-74%; 52%, 95% CI 47-57%, = 0.86) and the rate of ≥50% seizure-reduction of FCD (90%, 95% CI 80-100%; 90%, 95% CI 86-94%, = 0.42). Both methods had low complication rates (17.1%, 28/159) and long-term complication (2.5%, 4/159) rate, with no significant difference between them ( = 0.17).
Both MRgLiTT and SEEG-RFTC are safe and minimally invasive treatments for patients with FCD. They have comparable performance in terms of postoperative seizure-freedom rates in patients with FCD, and both can be used as treatment options for patients with FCD. Our study found that SEEG-RFTC had a better therapeutic effect in the FCD2b subgroup.
磁共振引导激光间质热疗（MRgLiTT）和立体定向脑电图引导射频热凝术（SEEG-RFTC）是治疗局灶性皮质发育不良（FCD）所致癫痫的两种有效微创治疗方法。本研究的目的是进行一项荟萃分析，以评估和比较这两种疗法在FCD癫痫患者中的疗效和安全性。
我们检索了PubMed、Embase、Cochrane等数据库中2023年3月之前发表的文章。主要目的是比较MRgLiTT和SEEG-RFTC在FCD癫痫患者中的有效性和并发症。第二个目的是确定哪种方法为特定亚组患者提供更好的预后。
根据纳入和排除标准，纳入18项研究，共270例FCD患者，其中6项MRgLiTT研究中的37例患者和12项SEEG-RFTC研究中的233例患者。MRgLiTT组和SEEG-RFTC组在无癫痫发作率（59%，95%CI 44-74%；52%，95%CI 47-57%，P=0.86）和FCD癫痫发作减少≥50%的比例（90%，95%CI 80-100%；90%，P=0.42）方面无显著差异。两种方法的并发症发生率（17.1%，28/159）和长期并发症发生率（2.5%，4/159）均较低，且两者之间无显著差异（P=0.17）。
MRgLiTT和SEEG-RFTC都是治疗FCD患者的安全微创治疗方法。它们在FCD患者术后无癫痫发作率方面表现相当，均可作为FCD患者的治疗选择。我们的研究发现，SEEG-RFTC在FCD2b亚组中具有更好的治疗效果。
