Analysis of the Relationship between Prognosis of Different Intractable Epilepsy Surgery and the Disease Course_West China Medical Journal

Authors：

LI Liang ¹ , ZENG Yijun ² , CHEN Jianbin ¹ , WANG Qiangping ² ,  LEI Ding ¹

1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 2. Department of Neurosurgery, Medical Center of Dujiangyan, Sichuan 611830, P. R. Chin;

Corresponding author：

LEI Ding, Email: 329274340@qq.com

Keywords：

难治性癫痫; 手术预后; 病程

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【摘要】　目的　探讨难治性癫痫不同类型手术的预后与病程长短有无相关关系。　方法　回顾性分析2005年1月-2009年12月在四川大学华西医院神经外科进行难治性癫痫手术的143例患者，根据Engel分级对预后进行评估，分别分析各类型手术不同病程时间之间的预后差异以及相关关系。　结果　不同病程组颞叶手术和颞叶合并颞叶外手术的预后差异无统计学意义（P gt;0.05），两者之间无相关关系；颞叶外手术的预后在不同病程组间差异有统计学意义（P lt;0.05），两者之间呈负相关。　结论　颞叶外癫痫手术的预后与病程存在相关关系；病程越短，预后越好。
【Abstract】　Objective　 To discuss the relationship between prognosis of different intractable epilepsy surgeries and the disease course.　Methods　 A total of 143 patients who had undergone surgeries for intractable epilepsy in the Neurosurgery Department of West China Hospital of Sichuan University from 2005 to 2009 were enrolled, and the prognosis with different disease course were assessed based on the Engel classification.　Results　 Between different disease duration groups, the difference between the prognosis of the temporal surgery and the surgery of temporal lobe combined with other lobes was not statistically significant (P gt;0.05), which indicated no relationship between the disease course and the prognosis. However, the difference between the prognosis of the surgeries outside the temporal lobe was statistically significant (P lt;0.05), which showed that patients with a longer disease course had a worse prognosis.　Conclusion　 The prognosis of the epilepsy surgery outside the temporal lobe is correlated with the disease course. The shorter course has a better prognosis after surgery.

Citation： LI Liang,ZENG Yijun,CHEN Jianbin,WANG Qiangping,LEI Ding. Analysis of the Relationship between Prognosis of Different Intractable Epilepsy Surgery and the Disease Course. West China Medical Journal, 2011, 26(2): 201-203. doi: Copy

1.
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4.	Kwan P, Brodie MJ. Definition of refractory epilepsy: defining the indefinable?[J]. Lancet Neurol, 2010, 9(1): 27-29.
5.	Wiebe S, Blume WT, Girvin JP, et al. A randomized, controlled trial of surgery for temporal-lobe epilepsy[J]. N Engl J Med, 2001, 345(5): 311-318.
6.	Engel J Jr. Surgical treatment of the epilepsies[M]. 2nd ed. New York: Raven Press, 1993: 609-621.
7.	Engel J Jr, Wiebe S, French J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons[J]. Neurology, 2003, 60(4): 538-547.
8.	Mohanraj R, Brodie MJ. Diagnosing refractory epilepsy: response to sequential treatment schedules[J]. EurJ Neurol, 2006, 13(3): 277-282.
9.	Stephen LJ, Kelly K, Mohanraj R, et al. Pharmacological outcomes in older people with newly diagnosed epilepsy[J]. Epilepsy Behav, 2006, 8(2): 434-437.
10.	Olivier A. Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy[J]. Can J Neurol Sci, 2000, 27(Suppl 1): S68-S76.
11.	Olivier A. Temporal resections in the surgical treatment of epilepsy[J]. Epilepsy Res, 1992, 5(Suppl 1): 175-188.
12.	Engel J Jr, Wiebe S, French J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy[J]. Epilepsia, 2003, 44(6): 741-751.
13.	Téllez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis[J]. Brain, 2005, 128(Pt 5): 1188-1198.
14.	Pomata HB, Gonzalez R, Bartuluchi M, et al. Extratemporal epilepsy in children: candidate selection and surgical treatment[J]. Childs Nerv Syst, 2000, 16(12): 842-850.
15.	Siegel AM, Cascino GD, Meyer FB, et al. Surgical outcome and predictive factors in adult patients with intractable epilepsy and focal cortical dysplasia[J]. Acta Neurol Scand, 2006, 113(2): 65-71.
16.	Lowe NM, Eldridge P, Varma T, et al. The duration of temporal lobe epilepsy and seizure outcome after epilepsy surgery[J]. Seizure, 2010, 19(5): 261-263.
17.	Dlugos DJ. The early identification of candidates for epilepsy surgery[J]. Arch Neurol, 2001, 58(10): 1543-1546.

1.
2. 　Wang WZ, Wu JZ, Wang DS, et al. The prevalence and treatment gap in epilepsy in China: an ILAE/IBE/WHO study[J]. Neurology, 2003, 60(9): 1544-1545.
3. 　谭启富, 胡志刚. 癫痫外科治疗在低收入人群中的策略[J]. 实用医院临床杂志, 2009, 6(4): 9-11.
4. 　Kwan P, Brodie MJ. Definition of refractory epilepsy: defining the indefinable?[J]. Lancet Neurol, 2010, 9(1): 27-29.
5. 　Wiebe S, Blume WT, Girvin JP, et al. A randomized, controlled trial of surgery for temporal-lobe epilepsy[J]. N Engl J Med, 2001, 345(5): 311-318.
6. 　Engel J Jr. Surgical treatment of the epilepsies[M]. 2nd ed. New York: Raven Press, 1993: 609-621.
7. 　Engel J Jr, Wiebe S, French J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons[J]. Neurology, 2003, 60(4): 538-547.
8. 　Mohanraj R, Brodie MJ. Diagnosing refractory epilepsy: response to sequential treatment schedules[J]. EurJ Neurol, 2006, 13(3): 277-282.
9. 　Stephen LJ, Kelly K, Mohanraj R, et al. Pharmacological outcomes in older people with newly diagnosed epilepsy[J]. Epilepsy Behav, 2006, 8(2): 434-437.
10. 　Olivier A. Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy[J]. Can J Neurol Sci, 2000, 27(Suppl 1): S68-S76.
11. 　Olivier A. Temporal resections in the surgical treatment of epilepsy[J]. Epilepsy Res, 1992, 5(Suppl 1): 175-188.
12. 　Engel J Jr, Wiebe S, French J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy[J]. Epilepsia, 2003, 44(6): 741-751.
13. 　Téllez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis[J]. Brain, 2005, 128(Pt 5): 1188-1198.
14. 　Pomata HB, Gonzalez R, Bartuluchi M, et al. Extratemporal epilepsy in children: candidate selection and surgical treatment[J]. Childs Nerv Syst, 2000, 16(12): 842-850.
15. 　Siegel AM, Cascino GD, Meyer FB, et al. Surgical outcome and predictive factors in adult patients with intractable epilepsy and focal cortical dysplasia[J]. Acta Neurol Scand, 2006, 113(2): 65-71.
16. 　Lowe NM, Eldridge P, Varma T, et al. The duration of temporal lobe epilepsy and seizure outcome after epilepsy surgery[J]. Seizure, 2010, 19(5): 261-263.
17. 　Dlugos DJ. The early identification of candidates for epilepsy surgery[J]. Arch Neurol, 2001, 58(10): 1543-1546.

West China Medical Journal

Analysis of the Relationship between Prognosis of Different Intractable Epilepsy Surgery and the Disease Course

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