海马硬化合并局灶性皮质发育不良致难治性颞叶癫痫手术预后的影响因素

ObjectiveTo study the prognostic factors of surgical operation in patients with refractory temporal lobe epilepsy(TLE) induced by dual pathology of hippocampal sclerosis(HS) with focal cortical dysplasia(FCD). MethodsThe clinical data of 45 patients with refractory TLE induced by pathological proved dual pathology(HS with FCD) were analyzed retrospectively. The postoperative follow-up ranged from 1 to 5years, according to the follow-up results. Engel classI-IIwere taken as the effective treatment group and Engel class III-IV were taken as the ineffective treatment group. The binary logistic regression analysis was used to investigate the factors influencing the prognosis of surgery. Results29 (29/45) patients were in the effective treatment group. Among them, 27 were Engel class Iand 2 were Engel class II. 16(16/45) patients were in the ineffective treatment group. Among them, 9 were Engel class III and 7 were Engel class IV. Binary logistic regression analysis showed that histopathological subtypes were FCDIIIa or not (χ2=4.593, P=0.032, OR=6.098, 95% CI=1.167-31.863) and complete resection of epileptogenic area or not(χ2=9.477, P=0.002, OR=13.487, 95% CI=2.574-70.679) were statistically significant. Onset age, preoperative seizure frequency, course of onset, age at operation, having a history of febrile seizure or not and positive or not on MRI were not statistically significant(P＞0.05). ConclusionThe operative prognoses of the patients with TLE induced by dual pathology(HS with FCD) are associated with histopathological subtypes, complete resection of epileptogenic area. [ABSTRACT FROM AUTHOR]