Influence of relapse of medically intractable temporal lobe epilepsy shortly after surgery in its long-term efficacy
10.3760/cma.j.issn.1671-8925.2014.07.012
- VernacularTitle:药物难治性颞叶癫痫术后短期内复发对远期疗效的影响
- Author:
Qiao SHAN
1
;
Shixun WANG
;
Peidong LI
;
Xinjun WANG
Author Information
1. 郑州大学第五附属医院神经外科
- Keywords:
Temporal lobe epilepsy;
Relapse;
Long-term efficacy
- From:
Chinese Journal of Neuromedicine
2014;13(7):699-702
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of drug refractory temporal lobe epilepsy relapse shortly after surgery in its long-term efficacy.Methods The clinical data of 57 patients with medically intractable temporal lobe epilepsy,underwent surgery from August 2010 to August 2011 in our hospital,were retrospectively analyzed; all the patients were performed surgery,and postoperative treatment of epilepsy (adjustment antiepileptic drugs) in our hospital and rehabilitation center was chosen;the parallel regular follow-up clinic or telephone was also performed.According to the relapse situation one year after surgery,these patients were divided into control group (no epilepsy,n=18) and experimental group (relapse,n=39).Follow-up data,long-term efficacy and overall efficacy between the two groups were analyzed.Results (1) Postoperative medial temporal lobe sclerosis,neoplastic lesions,mixed lesions and normal patients were 27,7,10 and 13,respectively,counting for 47.37%,12.28%,17.54% and 22.81% of the patients; (2) on the second year of surgery,patients in the experimental group had 44.44% satisfactory seizure control,which was significantly lower than those in the control group (74.36%,x2=4.839,P=0.028); (3) Kapan-Meier survival curve indicated that epilepsy remission rate in the control group was significantly higher than that in the experimental group on the second year of surgery (x2=5.928,P=0.017); (4) multivariate Logistic regression analysis showed that risk factors affecting the long-term efficacy included incentives recurrence (OR=4.511,95%CI:3.195-7.569),relapse frequency≥ 3 times (OR=4.281,95%CI:0.040-0.712) and recurrence of epilepsy type to complex partial seizure/generalized tonic-clonic seizures (OR=3.344,95%CI:3.186-8.400).Conclusion Drug refractory temporal lobe epilepsy relapse shortly after surgery will affect its long-term efficacy,and the determinate factors included incentives recurrence,relapse frequency≥ 3 times and recurrence of epilepsy type.