Pediatric Epilepsy Center, Peking University First Hospital, Beijing, China.
CNS Neurosci Ther. 2024 Sep;30(9):e70031. doi: 10.1111/cns.70031.
To investigate post-operative seizure outcomes, and predictors of surgical outcomes of the malformation of cortical development (MCD) in children with drug-resistant epilepsy (DRE) and age-specific characteristics.
We retrospectively analyzed clinical data from 428 children with MCD-related DRE who underwent curative surgical treatment. Statistical analyses were conducted to identify correlative characteristics, prognostic predictors, and differences among various age groups.
After more than 3 years of follow-up, 81.3% of patients achieved Engel I outcomes. Prognosis was correlated with factors such as age at surgery, MRI findings, invasive EEG, pathology, acute postoperative seizures (APOS), and the number of preoperative and postoperative anti-seizure medications (AEDs). Age at surgery and the number of preoperative AEDs (p < 0.001) were significant predictors of seizure recurrence. Distinct clinical characteristics were observed among different age groups.
Surgery is effective in terminating MCD-related DRE. Younger age at surgery and fewer preoperative AEDs are associated with better prognoses. Clinical characteristics vary significantly with age.
研究耐药性癫痫(DRE)伴皮质发育畸形(MCD)患儿术后癫痫发作结局和手术结局的预测因素,以及年龄特异性特征。
我们回顾性分析了 428 例 MCD 相关 DRE 行根治性手术治疗的患儿的临床资料。进行了统计学分析,以确定相关特征、预后预测因素以及不同年龄组之间的差异。
经过 3 年以上的随访,81.3%的患者达到了 Engel I 级结果。预后与手术年龄、MRI 表现、有创脑电图、病理学、术后急性发作(APOS)和术前及术后抗癫痫药物(AEDs)的数量等因素相关。手术年龄和术前 AEDs 的数量(p<0.001)是癫痫复发的显著预测因素。不同年龄组之间存在明显不同的临床特征。
手术对于终止 MCD 相关 DRE 是有效的。手术年龄越小和术前 AEDs 越少与预后越好相关。临床特征随年龄变化显著。