Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients
Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients
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DOI：
10.1016/0920-1211(96)00008-3
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发表时间：
1996-06-01
影响因子：
2.2
通讯作者：
Wyler, AR
中科院分区：
文献类型：
--
作者：
Davies, KG;Hermann, BP;Wyler, AR
关于海马硬化症（HS）是癫痫发作的既存原因还是后果存在争议。我们调查了122例在1989年至1992年间因难治性癫痫而接受前颞叶切除术的连续患者。除5例有HS外，MRI扫描正常。HS的程度从0到4分级。癫痫发作年龄与HS分级呈显著负相关（P < 0.0001），癫痫持续时间与HS分级呈正相关（P < 0.001）。使用HS的二分分组（HPSC-为0级和1级[无/轻度HS]，HPSC+为3级和4级[中度/显著HS]），HPSC+与儿童热性惊厥（CFS）史（P = 0.003）、癫痫发作的较早年龄（P < 0.001）和癫痫持续时间较长（P < 0.001）呈正相关。与特别长时间的个别癫痫发作史无关。控制癫痫发作时的年龄后的偏相关性表明，HPSC+和癫痫持续时间之间不再有显着的关系。癫痫病程延长后，HPSC+与发病年龄仍有显著相关性（P < 0.001）。控制发病年龄后，HPSC+与CFS的相关性非常显著。Logistic回归分析显示，发病年龄是HPSC+的唯一预测因素。它的结论是，这是支持证据预先存在的HS是颞叶癫痫的原因，而不是癫痫发作的后果。
Controversy exists as to whether hippocampal sclerosis (HS) is a preexisting cause or a consequence of seizures. We investigated 122 consecutive patients who underwent anterior temporal lobectomy for intractable epilepsy between 1989 and 1992. MRI scans were normal apart from evidence of HS in 5 cases. The degree of HS was graded from 0 to 4. There was a significant inverse correlation between age of seizure onset and grade of HS (P < 0.0001), and a positive, correlation between duration of epilepsy and grade of HS (P < 0.001). Using a dichotomous grouping of HS (HPSC- for grades 0 and 1[no/mild HS], and HPSC+ for grades 3 and 4 [moderate/marked HS]), there was a positive correlation between HPSC+ and a history of childhood febrile seizures (CFS) (P = 0.003), earlier age of onset of epilepsy (P < 0.001) and longer duration of epilepsy (P < 0.001). There was no correlation with history of particularly prolonged individual seizures. Partial correlations after controlling for age at onset of epilepsy showed that there was no longer a significant relationship between HPSC+ and duration of epilepsy. After controlling-for duration of epilepsy, the relationship between HPSC+ and age of onset remained significant (P < 0.001). The correlation between HPSC+ and CFS, controlling for age at onset, was hot significant, A series of logistic regression analyses showed age at onset to be the only predictor of HPSC+. It is concluded that this is supportive evidence for preexisting HS being a cause of temporal lobe epilepsy and not a consequence of seizures.