影响手术治疗难治性颞叶癫痫预后的危险因素探讨

目的探讨影响手术治疗难治性颞叶癫痫预后的危险因素.方法以手术方法治疗难治性颞叶癫痫患者42例,经至少1年随访,以术后癫痫发作频率系统对疗效进行评分,分析术前发作频率,婴儿期热性惊厥、脑炎、围产期脑损伤、颅内肿瘤、颅脑外伤等可能病因,可能病因发生年龄,发病年龄,手术年龄,病程和手术疗效的关系.结果发作频率≥1次/周者较＜1次/周者疗效差,两组间差异有显著性意义.有婴儿期热性惊厥患者与无婴儿期热性惊厥患者的疗效差异有显著性意义,前者优于后者.脑炎,围产期脑损伤,颅内肿瘤,颅脑外伤等可能病因,可能病因发生年龄,发病年龄,手术年龄,病程两组间差异无显著性意义.但经多重回归分析发现发作频率高是影响手术疗效的唯一危险因素.结论发作频率高是影响手术治疗难治性颞叶癫痫预后的唯一危险因素.

Risk factors affecting operative outcome of temporal lobe epilepsy

Objective To investigate risk factors the operative outcome of temporal lobe epilepsy. Methods The operative outcomes of 42 temporal lobe epilepsy cases were assessed after l or more years, with the preoperative seizure frequency, the history of febril seizure, the other possible pathogeny like encephalitis, perinatal brain injure, intracranial tumor, craniocerebral trauma, age of onset of the possible pathogeny, age of onset of epilepsy, age at surgery and course of epilepsy were compared. Results The average age at surgery, the duration of epilepsy, age of onset of the possible pathogeny expect for febril seizure, age at onset of epilepsy did not differ significantly between the two groups. But there were significant differences between patients with and without history of febril seizure and between patients with high seizure frequency and low seizure frequency. By mutiple regression, seizure frequency was the only risk factor of postoperative outcome. Conclusion High seizure frequency before operation may be the only risk factor which affects operative outcomes in the treatment of temporal lobe epilepsy.