额叶与颞叶局灶性皮质发育不良癫病人临床特征的比较

Comparison of clinical characteristics between epilepsy patients with frontal and temporal focal cortical dysplasias

目的研究额叶与颞叶局灶性皮质发育不良(focal cortical dysplasia,FCD)癫病人的临床特征。方法回顾性分析经病理确诊为FCD且病灶位于额叶或颞叶的48例癫病人的临床资料,其中额叶15例,颞叶33例。根据病理分型,轻度皮质发育不良(mild cortical dysplasia,MCD)8例,FCDⅠ型8例,FCDⅡ型16例,FCDⅢ型16例。分析额叶和颞叶病人在癫始发年龄、病程、癫发作类型、频率、脑电图双侧异常率、MRI异常率、抗癫药物数量及FCD病理亚型等方面的差异。结果额叶与颞叶FCD癫病人在性别、文化程度、癫始发年龄、发作类型及服用抗癫药物数量、脑电图双侧异常率等方面无显著差异(均P>0.05)。但两组在病理亚型上存在显著差异(P<0.001),额叶癫以FCDⅡ型为主,颞叶癫以FCDⅢ型多见。与颞叶相比,额叶病人病程更短、发作频率及MRI异常率更高(均P<0.05)。结论额叶FCD与颞叶FCD癫病人在病理分型、病程、癫发作频率、MRI异常率上可能存在差别,这些结果将有助于临床医生更好地认识FCD。

Objective To compare the clinical characteristics between epilepsy patients with frontal and temporal focal cortical dyspiasias （FCDs）. Methods Clinical data of 48 patients who were diagnosed with FCD localized in the frontal lobe or.temporal lobe were analyzed retrospectively, including 15 patients in the frontal lobe and 33 in the temporal lobe. According to pathological classification, mild cortical dysplasia （MCD） in 8 pat!ents, FCD type I in 8, FCD type Ⅱ in 16 and FCD type Ⅲ in 16. The clinical data including age at onset, duration of epilepsy, seizure types and frequency, rate of bilateral EEG abnormality and presence of MRI lesion, the number of antiepileptic drugs and FCD subtypes were compared between epilepsy patients with frontal and temporal FCDs. Results There was no significant difference in gender, education level, age at onset, seizure types, rate of bilateral EEG abnormality and the number of antiepileptic drugs between two groups （all P 〉 0.05）. However, FCD subtypes were significantly different between two groups （P 〈 0.001）, FCD type II was predominant in frontal FCD and FCD type III was main type in temporal FCD. Compared with temporal FCD, duration of epilepsy was significantly shorter, seizure frequency was higher and rate of MRI abnormality was significantly higher in frontal FCD （all P 〈 0.05）. Conclusion There are possible differences in pathological subtypes, duration of epilepsy, seizure frequency and rate of MRI abnormality between epilepsy patients with frontal and temporal FCDs, which will be helpful to the better understanding of FCD.