A study of medial and lateral temporal lobe epilepsy based on stereoelectroencephalography  

作　　者：Xiao-Ming Yan Cui-Ping Xu Yu-Ping Wang Kai Ma Tao Yu Xiao-Hua Zhang Xi Zhang Run-Shi Gao Guo-Jun Zhang Yong-Jie Li 

机构地区：[1]Beijing Institute of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [2]Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

出　　处：《Chinese Medical Journal》2021年第1期68-72,共5页中华医学杂志（英文版）

基　　金：supported by grants from the Beijing Natural Science Foundation(No.L182015);the Beijing Hospitals Authority’s Ascent Plan(No.DFL20190801)。

摘　　要：Background:Patients with temporal lobe epilepsy(TLE)originating from different seizure onset zones had distinct electrophysiological characteristics and surgical outcomes.In this study,we aimed to investigate the relationship between the origin and prognosis of TLE,and the stereoelectroencephalography(SEEG)features.Methods:Thirty patients with TLE,who underwent surgical treatment in our functional neurosurgery department from January 2016 to December 2017,were enrolled in this study.All patients underwent anterior temporal lobectomy after an invasive preoperative evaluation with SEEG.Depending on the epileptic focus location,patients were divided into those with medial temporal lobe seizures(MTLS)and those with lateral temporal lobe seizures(LTLS).The Engel classification was used to evaluate operation effectiveness,and the Kaplan-Meier analysis was used to detect seizure-free duration.Results:The mean follow-up time was 25.7±4.8 months.Effectiveness was 63.3%for Engel I(n=19),13.3%for Engel II,3.3%for Engel III,and 20.0%for Engel IV.According to the SEEG,60.0%(n=18)had MTLS,and 40.0%(n=12)had LTLS.Compared with the MTLS group,the operation age of those with LTLS was significantly greater(26.9±6.9 vs.29.9±12.5 years,t=-0.840,P=0.009)with longer epilepsy duration(11.9±6.0 vs.17.9±12.1 years,t=-1.801,P=0.038).Patients with MTLS had a longer time interval between ictal onset to seizure(67.3±59.1 s vs.29.3±24.4 s,t=2.017,P=0.008).The most common SEEG ictal pattern was a sharp/spike-wave rhythm in the MTLS group(55.6%)and low-voltage fast activity in the LTLS group(58.3%).Compared with the LTLS group,patients with MTLS had a more favorable prognosis(41.7%vs.77.8%,P=0.049).Post-operative recurrence was more likely to occur within three months after the operation for both groups,and there appeared to be a stable longterm outcome.Conclusion:Patients with MTLS,who accounted for three-fifths of patients with TLE,showed a more favorable surgical outcome.

关 键 词：EPILEPSY Stereoelectroencephalography Surgical outcome Temporal lobe 

分 类 号：R742.1[医药卫生—神经病学与精神病学]