单侧海马硬化颞叶癫痫患者头皮脑电图发作间期棘波频率与手术疗效的关系

目的:评估单侧海马硬化的颞叶癫痫患者头皮脑电图发作间期棘波(interictal spike,IEDs)频率与手术疗效的关系。方法:回顾性分析33例单侧海马硬化的颞叶癫痫患者头皮脑电图,随机抽取手术前1h清醒期脑电图分析其IEDs频率和分布,并据此将患者分为2类:(1)IEDs高频组和IEDs低频组;(2)IEDs单侧颞叶组和IEDs双侧颞叶组。患者经1年以上随访统计预后。用Fisher确切检验法、广义线性模型分析IEDs频率与手术疗效的关系。结果:IEDs低频组17例,其中16例(94.1%)术后发作消失;IEDs高频组16例,其中10例(62.5%)术后发作消失,两组间疗效差异存在显著性(P=0.039)。患者先兆和全面性发作的存在、病程与患者IEDs频率正相关。结论:单侧海马硬化颞叶癫痫患者清醒期IEDs频率高预示手术疗效不良。

Interictal spike frequency correlations with outcome for temporal lobe epilepsy with unilateral hippocampal sclerosis

Objective To assess the implications of the interictal spike frequency over the affected temporal lobe for temporal lobe epilepsy(TLE) with unilateral hippocampal sclerosis.Methods We retrospectively analyzed the electroencephalogram(EEG) of 33 TLE patients with unilateral hippocampal sclerosis who underwent anterior temporal resection.Preoperative 1-h interictal EEGs of wake states were evaluated for interictal spikes.Patients were catergorized according to spike frequency(frequent spike group vs.non-frequent spike group) and spike distribution(uni-temporal group vs.bi-temporal group).Patients were classified by Engle classification for 1 year at least after surgery.Fisher exact test and generalized linear models were used to analysis the relation between the interictal spikes and outcome.Results Sixteen of seventeen(94.1%) patients’ seizure disappeared in frequent spike group,but only 10 of 16(62.5%) patients in non-frequent spike group(P=0.039).Duration of epilepsy,the existence of general seizure and aura is positive correlation with interictal spikes frequency.Conclusion High spike frequency is a predictor for poor outcome.