A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy
A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy
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DOI：
10.1212/01.wnl.0000343850.85763.9c
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发表时间：
2009-03-03
期刊：
影响因子：
9.9
通讯作者：
Frey, M.
中科院分区：
文献类型：
--
作者：
Kanner, A. M.;Byrne, R.;Frey, M.
目的：确定精神和癫痫变量预测术后癫痫发作的结果后前颞叶切除术（ATL）。方法：回顾性研究100例连续颞叶癫痫（TLE）谁接受ATL。平均（+/- SD）随访期为8.3（+/- 3.1）年。在术后2年和末次联系时检查了三种类型的手术结局：IA级（无致残性癫痫发作，无先兆）、IA + IB级（无致残性癫痫发作）和IA + IB + IC级（术后第一年无或罕见致残性癫痫发作）。分别对三种类型的手术结局进行Logistic回归分析。癫痫相关的独立变量包括发病年龄、TLE病因（颞叶内侧硬化、病灶和隐源性TLE）、内侧结构切除程度、神经病理学异常、仅复杂部分性癫痫发作和癫痫发作持续时间。精神独立变量包括术后和术前的生活史的情绪，焦虑，注意缺陷多动，和精神病disorders.Results：精神病史的情况下是一个独立的预测所有三种类型的手术结果。此外，较大的近中结构切除是IA级结局的预测因子，仅复杂部分性癫痫发作（与全身强直阵挛性癫痫发作相比）是IA + IB和IA + IB + IC级的预测因子。有内侧颞叶硬化症（与其他原因的TLE）是预测IA + IB + IC类，以及.Conclusions：这些数据表明，一生的精神病史可能是预测一个更糟糕的postsurgical癫痫发作后的结果前颞叶切除术。神经病学（R）2009; 72：793-799
Purpose: To identify the psychiatric and epilepsy variables predictive of postsurgical seizure outcome after anterotemporal lobectomy (ATL).Methods: Retrospective study of 100 consecutive patients with temporal lobe epilepsy (TLE) who underwent ATL. The mean (+/- SD) follow-up period was 8.3 (+/- 3.1) years. Three types of surgical outcomes were examined at 2 years after surgery and at last contact: class IA (no disabling seizures no auras), class IA + IB (no disabling seizures), and class IA + IB + IC (no or rare disabling seizures in the first postsurgical year). Logistic regression analyses were performed separately for the three types of surgical outcomes. The epilepsy-related independent variables included age at onset, cause of TLE (mesial temporal sclerosis, lesional and cryptogenic TLE), extent of resection of mesial structures, neuropathologic abnormalities, having only complex partial seizures, and duration of the seizure disorder. The psychiatric independent variables included a postsurgical and presurgical lifetime history of mood, anxiety, attention deficit hyperactivity, and psychotic disorders.Results: The absence of a psychiatric history was an independent predictor of all three types of surgical outcomes. In addition, a larger resection of mesial structures was a predictor for class IA outcome, and having only complex partial seizures (vs generalized tonic-clonic seizures) was a predictor for class IA + IB and IA + IB + IC. Having mesial temporal sclerosis (vs other causes of TLE) was a predictor for class IA + IB + IC as well.Conclusions: These data indicate that a lifetime psychiatric history may be predictive of a worse postsurgical seizure outcome after an anterotemporal lobectomy. Neurology (R) 2009; 72: 793-799