不同亚型FCD癫痫患者手术部位、影像特点及术后疗效分析

Analysis of different subtypes of FCD patients with epilepsy in surgical position、imaging features and postoperative effect

目的探讨不同亚型局灶性脑皮质发育不良(focal cortical dysplasia,FCD)癫痫手术部位、影像学及其术后疗效等方面的差异。方法回顾性分析了我癫痫中心72例FCD患者的术后资料,对其手术部位、术后疗效、药物应用、影像学进行了系统地整理归纳。应用SPSS软件对不同亚型患者进行术后疗效及相关因素分析。结果FCD癫痫患者最常见手术部位在颞叶(41.67%),其次为额叶(18.06%),FCDⅡ型较其他两型在核磁共振图像上主要表现为灰白质分界不清,而较少有异常脑回和皮层信号增高,FCDⅢ型更多的是病变部位高信号。FCD术后有91.7%(66例)患者还口服一种或一种以上药物治疗,术后FCDⅡ型未服药人数要高于FCDⅠ型和FCDⅢ型。不同亚型FCD术后半年和一年疗效无明显差异。结论 FCD癫痫患者术后半年总体有效率达到54.2%,不同亚型FCD在手术部位、影像学等方面也存在差异,这为今后FCD型癫痫手术起到指导作用。

Objective To explore the difference of different subtypes of Focal cortical dys- plasia（FCD） patients with epilepsy in surgical position .imaging features and postoperative effect Methods 72 cases of FCD patients with postoperative data were analyzed in our epilepsy center retrospectively, we summarized the surgical position, postoperative effect, drug application and im- aging of the patients. SPSS software were used to analyze the related factors and postoperative effect of different types. Results The most common FCD surgery in patients with epilepsy loca- ted in temporal lobe（41.67%）,followed by frontal lobe（18.06%）. FCD II showed mainly blurred gray--white matter transition .less abnormal gyration and increased subcortical signal intensity comparing the other types. FCDⅢ type showed more increased subcortical signal. There were 91. 7% （66 cases） patients with one or more drug treatments after FCD surgery,the numbers of FCD Ⅱ without taking drugs after surgery were more than FCD Ⅰ and FCDⅢ. The surgical effect after one year or half a year of different types of FCD showed no difference. Conclusion The postoper- ative effect of FCD patients with epilepsy after the first half of the year reached 54.2%, There were also differences between different subtypes of FCD in the surgical position.imaging and oth- er aspects,it mayguide the futural epilepsy surgery of FCD.