丙戊酸钠注射液在颞叶癫痫术后预防癫痫发作的围手术期护理效果研究

目的:研究在行颞叶癫痫术患者围手术期护理中实施丙戊酸钠注射液干预对于预防癫痫发作的影响。方法:选取我院自2008年10月5日至2012年10月8日期间收治的73例行颞叶癫痫术患者,采用随机数字表法形式将73例患者分为两组,采取我院常规术后护理的37例患者作为参照组,采取丙戊酸钠注射液护理的36患者作为实验组,对比两组患者术后满意度以及癫痫发作率。结果:经对症治疗后,实验组患者复发率16.67%、总有效率97.22%等指标对比参照组之间存在显著性差异,P值均小于0.05,具有统计学意义。结论:在颞叶癫痫术后围手术期护理中实行丙戊酸钠注射液干预可以显著降低癫痫发作率,改善术后患者生存质量。

Diagnosis and surgical treatment of temporal lobe epilepsy

Objective To discuss the diagnosis and surgical treatment of temporal lobe epilepsy.Methods From 1996 to 1998, 36 patients presenting with medically intractable temporal lobe epilepsy were identified by EEG and MR, including volumetric MR, for hippocampal formation. Among them, 16 patients underwent anterior temporal lobectomy, while 20 patients accepted selective amygdalohippocampectomy. The results of surgical operation and follow-up are analyzed.Results With respect to seizure outcome, all patients benefited from surgery. The surgical results were satisfactory in 24 cases, notable in 11 cases, and good in 1 case, and there were no complications.Conclusion MR is beneficial for the localization of epileptic foci. Surgery is an effective method for the treatment of temporal lobe epilepsy; selective amygdalohippocampectomy is the first choice for medial temporal lobe epilepsy. The transzygmatic-temporal lobe base approach presented in this study improved the safety of the surgery.

Determination of the dominant language hemisphere by functional MRI in patients with temporal lobe epilepsy

Abstract:Objective To determine the dominant language hemisphere in patients with intractable temporal lobe epilepsy before surgical treatment by using functional MRI (fMRI). Methods Twelve patients underwent fMRI. Among them, 4 patients also underwent the Wada test. Anterior temporal lobectomy was performed on patients with epileptic focus on the non-dominant hemisphere, and selective amygdalo-hippocampectomy on patients with epileptic focus on the dominant hemisphere.Results Ten patients had left dominance, and 2 right dominance. The fMRI results were concordant with Wada test results in the 4 patients who accepted the Wada test. Seven patients underwent anterior temporal lobectomy, and 5 underwent selective amygdalo-hippocampectomy. There was no post-operative dysphasia. Conclusion fMRI is an alternative method of noninvasive functional mapping for language dominance in patients with temporal lobe epilepsy.

Identification of serum biomarkers for evaluating seizure outcome after resective epilepsy surgery

Although patients with drug-resistant temporal lobe epilepsy(TLE)achieve good seizure control with resective surgery combined with anti-epileptic drugs(AEDs)treatment,it is still not clear when to withdraw AEDs after the surgery due to a lack of objective strategy for assessing the surgery outcome.Our aim is to identify objective and efficient biomarkers for assessment of surgery outcome to guide postoperative pharmacotherapy.Here,we detected 469 proteins differentially expressed between pre-and post-operative sera of TLE patients with postoperative seizure freedom,and identified six candidate proteins(HBA1,HBB,PRDX2,CA1,CAT and BLVRB)for validation.These six proteins were significantly reduced within three months after surgery,indicating these proteins may be potential biomarkers to assess the surgery outcome for TLE patients in the early stage.Interestingly,we found HBA1 to HBB ratio was superior to individual proteins to evaluate the postoperative surgery outcome with 90.0%sensitivity,90%specificity and area under the curve of 0.960.We also suppose these proteins were derived from epilepsy foci due to the rat experiment results that HBA1,HBB,PRDX2,CA1 and CAT were highly expressed in cerebrospinal fluid of epilepsy rat models.Additionally,HBA1,HBB,PRDX2,CA1 and BLVRB proteins were highly expressed in the sera of TLE patients with postoperative seizure freedom when compared to TLE patients with postoperative seizure and patients with other types of epilepsy,suggesting surgery outcome or the original sites of seizure might be assessed before the operation through monitoring these protein levels in the sera.Our study provides experimental data for establishing objective indicators for assessing seizure freedom after resective surgery and also proposed potential markers for specific diagnoses of TLE and prediction of TLE surgery outcome.