LONG-TERM FOLLOW-UP OF STEREOTAXIC LESIONECTOMY IN PARTIAL EPILEPSY - PREDICTIVE FACTORS AND ELECTROENCEPHALOGRAPHIC RESULTS
LONG-TERM FOLLOW-UP OF STEREOTAXIC LESIONECTOMY IN PARTIAL EPILEPSY - PREDICTIVE FACTORS AND ELECTROENCEPHALOGRAPHIC RESULTS
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DOI：
10.1111/j.1528-1157.1992.tb02340.x
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发表时间：
1992-07-01
期刊：
影响因子：
5.6
通讯作者：
TRENERRY, MR
中科院分区：
文献类型：
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作者：
CASCINO, GD;KELLY, PJ;TRENERRY, MR
我们进行了一项扩展的随访研究，评估立体定向病灶切除术在23例外来组织病变和难治性部分性癫痫患者中的疗效。16个病变涉及功能或功能皮层，由解剖定位确定。根据定义，这些患者的手术目的是切除病变，而不是周围的大脑皮质。平均随访时间为48.5个月（范围26-69个月）。17例患者（74%）在病灶切除术后癫痫发作显著减少（≥ 90%）。13例患者（56%）具有I类手术结局（无癫痫、单次癫痫发作或仅先兆）。其中5例患者成功停止抗癫痫药物（AED）治疗。颞叶病变的患者在统计学上不太可能成为无脑梗死患者（p < 0.05）。手术年龄、癫痫持续时间和基础病理学不是癫痫发作结局的显著预测因素。颅外EEG记录的癫痫样活动的解剖分布似乎不是结果的重要决定因素。术后3个月EEG中发作间期癫痫样活动的缺失与癫痫发作的显著减少相关。长期随访表明，病灶切除术可能是有效的选择患者与医学难治性部分癫痫发作障碍。
We performed an extended follow-up study assessing the efficacy of stereotactic lesionectomy in 23 patients with foreign-tissue lesions and intractable partial epilepsy. Sixteen lesions involved functional or eloquent cortex as determined by anatomic localization. By definition, the surgical objective in these patients was excision of the lesion, and not the surrounding cerebral cortex. The mean duration of follow-up was 48.5 months (range 26-69 months). Seventeen patients (74%) had a significant reduction in seizures (greater-than-or-equal-to 90%) after lesionectomy. Thirteen patients (56%) had a class I operative outcome (seizure-free, single seizure episode, or auras only). Five of these patients were successfully discontinued from antiepileptic drug (AED) therapy. Patients with temporal lobe lesions were statistically less likely to be rendered seizure-free (p < 0.05). Age at operation, duration of epilepsy, and underlying pathology were not significant predictors of seizure outcome. The anatomic distribution of extracranial EEG recorded epileptiform activity did not appear to be an important determinant of outcome. The absence of interictal epileptiform activity in the 3-month postoperative EEG correlated with a significant reduction in seizures. Long-term follow-up indicates that lesionectomy may be effective in select patients with medically refractory partial seizure disorders.