摘要
目的 探讨局灶性脑皮质发育不良(focal cortical dysplasia,FCD)致难治性癫痫(intractable epilepsy,IE)手术预后的影响因素。方法 回顾性分析2009年12月至2012年12月新疆医科大学第一附属医院手术的61例FCD致IE的手术效果。应用Logistic回归分析探讨FCD致IE预后的影响因素。结果 本组随访1~3年,术后预后良好(Engel I级)42例,预后不良19例(Ⅱ级10例,Ⅲ级5例,Ⅳ级4例)。Logistic回归分析显示FCD I型、致痫灶未完全切除、脑电图发作间期痫样波(interictal epileptiform discharge,IED)与病灶脑叶不一致为影响预后的独立危险因素,其OR值及95%可信区间分别为5.409[1.171,24.970]、4.760[1.104,20.528]、4.315[1.015,18.349],而年龄、民族、性别、头颅MRI检查结果、致痫灶所在脑叶位置对预后无明显影响。结论 FCDⅡ型、致痫灶完全切除、发作间期痫样波与病灶脑叶一致均与手术预后良好相关。
Objective To analyze the factors affecting the clinical outcomes of surgical operation in patients with focal cortical dysplasia (FCD)-related intractable epilepsy (IE). Methods We retrospectively analyzed surgical outcomes of 61 patients with FCD-related IE in The First Teaching Hospital of Xinjiang Medical University from December 2009 to December 201:2. Results All cases were followed up for 1-3 years. Forty-two cases (68.8%) were Engel class I, 29 (16.4%) class Ⅱ, 5 (8.2%) class Ⅲ and 4 patients (8.2%) class Ⅳ. Logistic regression showed that FCD type I, incom- plete resection and interictal epileptiform discharge (IED)-lesion mismatch were independent prognostic factors. Age, race, gender, brain MRI and the location of epileptogenic zone were not prognostic factors after surgery in patients with FCD-related IE. Conclusion FCD type Ⅱ, complete resection and IED-lesion match are significantly associated with favorable surgical outcome.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2014年第9期513-516,共4页
Chinese Journal of Nervous and Mental Diseases