Prognostic factors in patients with mesial temporal lobe epilepsy
Prognostic factors in patients with mesial temporal lobe epilepsy
复制标题
DOI：
10.1111/j.1528-1167.2008.01969.x
复制
发表时间：
2009-01-01
期刊：
影响因子：
5.6
通讯作者：
Tinuper, Paolo
中科院分区：
文献类型：
--
作者：
Pittau, Francesca;Bisulli, Francesca;Tinuper, Paolo
目的：探讨与内侧颞叶癫痫（MTLE）患者预后相关的临床、电生理和神经放射学因素。研究136例MTLE患者的家族史、临床特征、仪器数据[脑电图（EEG）、视频脑电图（video-EEG）、神经影像学]和预后。人群分为耐药组（DR: 108例，79.4%）和非耐药组（NDR: 28例，20.6%）；对两组的所有变量进行分析。两组比较显示治疗抵抗与发热性癫痫发作（FS） （DR 43.5% vs. NDR 17.8%, p = 0.008）、内侧颞叶硬化（MTS） （DR 64.8% vs. NDR 32.1%, p = 0.0025）、癫痫发作年龄早（DR 23.1% vs. NDR 3.6% p = 0.0160）和癫痫样间期异常（DR 89.7% vs. NDR 68%, p = 0.010）之间的关系。有MTS的患者发生FS的频率高于无MTS的患者（46.28%比26.3%,p = 0.0199）。69例患者行手术治疗，85.3%的患者预后良好。MTLE是一种异质性综合征。确定导致耐药和与耐药相关的因素对于治疗目的很重要，因为耐药的及时诊断必须导致早期手术治疗。本研究显示，FS、MTS、发病年龄早、癫痫样间期异常为不良预后因素，FS与MTS相关。
To disclose clinical, electrophysiologic, and neuroradiologic factors correlated to prognosis in patients with mesial temporal lobe epilepsy (MTLE).One hundred thirty-six MTLE patients were studied for family history, clinical characteristics, instrumental data [electroencephalography (EEG), video-EEG, neuroimaging], and outcome. The population was divided into drug-resistant (DR: 108 patients, 79.4%) and non-drug-resistant (NDR: 28 patients, 20.6%) groups; all variables were analyzed in the two groups.The comparison between the two groups shows a relation between resistance to therapy and febrile seizures (FS) (DR 43.5% vs. NDR 17.8%, p = 0.008), mesial temporal sclerosis (MTS) (DR 64.8% vs. NDR 32.1%, p = 0.0025), early age at seizure onset (DR 23.1% vs. NDR 3.6% p = 0.0160), and epileptiform interictal abnormalities (DR 89.7% vs. NDR 68%, p = 0.010). FS were more frequent in patients with MTS than in patients without (46.28% vs. 26.3%, p = 0.0199). Sixty-nine patients underwent surgery and 85.3% of them had a good outcome.MTLE is a heterogeneous syndrome. Establishing the factors responsible for and associated with drug resistance is important for therapeutic purposes, as prompt diagnosis of drug resistance must lead to early surgical management. This study shows that FS, MTS, early age at seizure onset, and epileptiform interictal abnormalities are negative prognostic factors and that FS are related to MTS.