不同局灶性皮层发育不良病理分型颞叶癫痫患者临床特征比较

A comparative study on clinical characteristics of different focal cortical dysplasia associated with temporal epilepsy

目的按照国际抗癫痫联盟(ILAE)分类对颞叶局灶性皮层发育不良(FCD)癫痫患者进行分类,比较不同FCD分型患者的临床特征。方法对收治的58例颞叶癫痫手术患者的临床资料、病理资料进行回顾性分析,根据2011年ILAE分型标准进行病理分型,将FCD分为单纯型FCD和结合型FCD,比较这两种病理分型患者癫痫的发作开始年龄、患病年限、手术治疗效果等临床特点,观察两种病理分型的FCD患者的上述指标是否存在差异。结果病理结果显示单纯型24例,结合型34例;所有患者随访1~4年,结合型FCD患者的发作年龄(19.2±3.6岁)晚于单纯型FCD(22.6±4.7岁)(P=0.041);结合型FCD患病年限(7.4±2.6年)短于单纯型FCD(5.9±1.9年)(P=0.012)。按照Engel标准,结合型FCD的手术效果良好率(82.8%)高于单纯型FCD(72.9%),结合型FCD的预后好于单纯型FCD。结论结合型FCD发作起始年龄晚于单纯型FCD,患病年限短于单纯型FCD,而且手术效果和预后好于单纯型FCD。

Objective According to the classification of International Union Against Epilepsy（ ILAE） for patients with temporal lobe focal cortical dysplasia（ FCD）,the clinical characteristics of patients with different types of FCD were compared. Methods The clinical data of 58 patients with temporal lobe epilepsy after surgery were retrospectively analyzed. FCD is divided into simple FCD and combined FCD according to ILAE criteria（ 2011） for pathological classification. The onset of epilepsy,duration of illness,the effect of surgical treatment etc in patients with simple FCD or combined FCD were analyzed and compared. Whether or not with difference in above indexes was to be studied. Results All these patients were followed up for 1- 4 years. The onset of age in patients with combined FCD was（ 19. 2 ± 3. 6） years old,it was later than that of patients with simple type FCD（ 22. 6 ± 4. 7） years old（ P = 0. 041）. The duration of illness in patients with combined FCD was（ 7. 4 ± 2. 6）years,and it was shorter than that（ 5. 9 ± 1. 9 years） of patients with simple FCD（ P = 0. 012）. According to the Engel criteria,patients with combined FCD had better outcome rate（ 82. 8%） than that of patients with simple FCD（ 72. 9%）,and the prognosis of patients with combined FCD was better than that of patients with simple FCD. Conclusion The time of onset in patients with combined FCD is later than that of patients with simple FCD. The course of illness in patients with combined FCD is shorter than that of patients with simple FCD. The effect of surgical treatment and prognosis of patients with combined FCD are better than those of patients with simple FCD.