Postoperative prognostic analysis of patients with MR imaging-negative temporal lobe epilepsy
10.3760/cma.j.issn.1671-8925.2017.06.015
- VernacularTitle:MRI阴性的颞叶癫痫术前评估与预后的关系研究
- Author:
Haiqing XU
1
;
Chunjie SONG
;
Peiwei CAO
;
Chunsheng ZHAO
Author Information
1. 221009,徐州市中心医院神经内科
- Keywords:
Temporal lobe epilepsy;
Prognois;
Pre-surgical evaluation
- From:
Chinese Journal of Neuromedicine
2017;16(6):616-619
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine whether unilateral-only interictal discharges on pre-surgical scalp EEG or multimodal pre-surgical evaluation are associated with surgical outcomes in patients with MR imaging-negative temporal lobe epilepsy (TLE) who underwent standard anterior temporal lobectomy (ATL). Methods One hundred and seventeen patients with TLE who underwent standard ATL from January 2000 to December 2013 were enrolled. According to the seizures at interictal period, these patients were divided into unilateral-only interictal discharge group (n=54) and bilateral interictal discharge group (n=63). According to the preoperative assessment, these patients were divided into multimodal evaluation group (n=72, two and above evaluation strategies besides electroencephalogram) and single modal evaluation group (n=45, electroencephalogram+one evaluation strategy). Follow-up for 12 months was performed; postsurgical outcomes included excellent outcome, defined as Engel class I, and non-excellent outcome, defined as Engel II-IV. Kaplan-Meier survival analysis and Cox proportion hazards were performed to compare the prognoses of patients from different groups. Results Totally, 73 patients (62.4%) achieved excellent outcome following ATL. In 54 with unilateral-only interictal discharges, 41 had excellent outcome; and in 63 with bilateral interictal discharge group, 32 patients had excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). Fifty of 72 patients receiving multimodal pre-surgical evaluation achieved excellent outcome, and 25 of 45 receiving single modal evaluation achieved excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). However, the patients with unilateral-only interictal discharges receiving multimodal pre-surgical assessment did not achieve further excellent outcomes as compared with those receiving single modal evaluation, without significant difference (P>0.05). Conclusion Multimodal pre-surgical evaluation is associated with better outcomes following standard ATL in the patients with MR imaging-negative TLE; however, for patients with unilateral-only interictal discharges, multimodal pre-surgical evaluation method may be not essential as compared with single modal pre-surgical evaluation method.
