Postoperative long-term outcomes and their influencing factors of patients with frontal lobe epilepsy due to focal cortical dysplasia
10.3760/cma.j.issn.1671-8925.2017.10.004
- VernacularTitle:额叶局灶性皮质发育不良癫痫患者术后长期疗效及影响因素分析
- Author:
Cuiping XU
1
;
Wei DU
;
Tao YU
;
Guojun ZHANG
;
Ping ZHUANG
;
Yuping WANG
;
Yongjie LI
Author Information
1. 首都医科大学宣武医院北京市功能神经外科研究所
- Keywords:
Focal cortical dysplasia;
Epilepsy;
Frontal lobe;
Long-term outcome
- From:
Chinese Journal of Neuromedicine
2017;16(10):989-993
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the postoperative long-term seizure outcomes and prognostic factors in frontal lobe epilepsy (FLE) patients with a histopathological diagnosis of focal cortical dysplasia (FCD).Methods The clinical data of 32 FLE patients with histopathologically proven FCD,admitted to our hospital from January 2009 to October 2011,were retrospectively analyzed.Postoperative follow up was performed for more than 3 years,and according to the prognoses,these patients were divided into seizure-free group and seizure group;and according to the pathological results,these patients were divided into FCD type Ⅰ and FCD type Ⅱ groups.Seizure outcomes were measured by Engel's classification and Kaplan-Meier analysis.Results (1) After a mean follow-up of 51.0± 11.5 months,18 patients (56.3％) were seizure-free.Patients from seizure-free group had significantly higher MRI positive rate and lower percentage of intracranial electrode embedment than patients from seizure group (P＜0.05);based on Kaplan-Meier analysis,the estimated probability of complete seizure-freedom in MRI positive patients was significantly higher than that in MRI negative patients (x2=5.080,P=0.024);the estimated probability of complete seizure-freedom in patients accepted direct epileptogenic focus resection was significantly higher than that in patients accepted intracranial electrode embedment (x2=4.412,P=0.036).(2) A mean follow-up of 53.5±11.7 months was performed in patients from FCD type Ⅰ group;6,3,2,and 4 patients were with Engel grading Ⅰ-Ⅳ,respectively;a mean follow-up of 48.8 ±11.2 months was performed in patients from FCD type Ⅱ group;12,3,2,and 0 patients were with Engel grading Ⅰ-Ⅳ,respectively;and significantly difference was noted between the two types (x2=5.181,P=0.023).The estimated probability of complete seizure-freedom in patients from FCD type Ⅱ group was 58.8％,which was significantly higher than that in patients from FCD type Ⅰ group (33.3％,x2=1.535,P=0.215).(3) In patients with early recurrence,one,2,4 and 3 patients were with Engel grading Ⅰ-Ⅳ,respectively;in patients with late recurrence,2,4,0 and one patients were with Engel grading Ⅰ-Ⅳ,respectively;significant difference was noted between patients with early/late recurrence (x2=5.130,P=0.024).Conclusions Postoperative long-term seizure outcome is favorable in FLE patients with FCD.MRI reveales to be predictive for the postoperative outcome and FCD type Ⅰ patients have a less favorable outcome than FCD type Ⅱ patients.
