The Follow-up And The Long-term Outcome Assessment Of AEDs Refractory Temporal Lobe Epilepsy Patients With Recurrent Seizures Shortly After Surgery

Objective: Through analysis the clinical features of drugrefractory temporal lobe epilepsy (TLE) patients that relapse in apostoperative short-term (<1year), combining with their preoperativeevaluation and postoperative follow-up related materials, we evaluate theinfluence of the recurrence on the long-term outcome and the patients’overall curative effect. We provide some advice of the preoperativeevaluation, treatment and follow-up for patients with temporal lobeepilepsy; discuss what cause the temporal lobe epilepsy surgery failureand look for the way improving the temporal lobe epilepsy surgerycurative effect furtherly. Methods: Collect luzhou medical schoolaffiliated363hospital neurosurgery in January2008to June200957patients underwent drug refractory temporal lobe epilepsy diagnosis andtreatment of patients with complete medical records, including itscharacteristics, operation scheme, history2years of follow-up data. All57patients preoperative both by1.5T head mri (magnetic resonanceimaging)(1.5TMRI),24hour dynamic video electroencephalogram (24hVEEG) sure epileptogenic zone position and scope, the nerve surgerygroup, our function in epilepsy and treatment center, our internal relateddepartment nerve joint consultation clear after drug refractory temporal lobe epilepsy diagnosis and surgical indications, perfect routinepreoperative examination. All patients accepted surgery, and thepreoperative preoperative and Picasso was repeated use20guide barshape electrode intraoperational cortex monitoring samples of thelocation and scope of discharge, further defined? operation area.Postoperative all patients in our epilepsy treatment center adjustantiepileptic (AEDs) use plan, do outpatient or telephone regularly, andfollow-up time27months~49months (mean32.53months). All patientsin the first years after have Epilepsy group and control group is dividedinto recurrence, and the postoperative1years for a recurrence of Epilepsypatients, including reference International antiepileptic League(International League Against Epilepsy, ILAE)2001congress standard,recurrence time points, have without recurrence incentive, recurrence,recurrent frequency into different types of single factor and group, thecontrol group for the first years after is completely Epilepsy patients.All the test data with software SPSS13.0do statistics processing, P <0.05as a statistical significance. Results: All patients in the first year after aseizure of recurrent (group)18cases (31.58%of all patients), the firstyears after the no relapse (control group)39cases (68.42%of all patients).Postoperative disease inspection results have no obvious discrepancy in13, including10patients (76.92%) belong to the experimental group, hasthe highest percentage of recurrence, tumor disease recurrence after one year the lowest proportion, the independent sample material of thechi-square test, the pathological type recurrence of the proportion of thegroup are statistically significant difference (P <0.05). In all patients was17.37%(27cases) during follow-up at least1times recurrent seizures,66.67%of them (that is, the patients) first seizure recurrence afterappeared in the first years, most of the patients (66.67%) for the first timeappear in epilepsy recurrence after29days or longer. Through theindependent sample material. Conclusion: Drug refractory temporal lobeepilepsy patients after one year of recurrent seizures are not relapses offorward and overall poor effects: postoperative pathologic result patientswith normal more precise nerve pathology with abnormal more easily inthe short term after have seizures recurrences: epilepsy recurrence haveincentives, and recurrence rate three times and frequency CPS/GTCS asthe main attack types in the long-term surgery patients is not the idealeffect of independent risk factors. On postoperative recurrence ofepilepsy TLE patients should stick to follow-up, and rationally adjust theantiepileptic drug use plan control seizures, minimize neurologicaldamage. There is a clear indication of another operation, should be ascientific comprehensive preoperative again, another operation as soon aspossible.