Contrast The Different Disease Course Of Temporal Lobe Epilepsy Patient’s Postoperative Effects And Analysis Of The Relationship Between Disease Course And Postoperative Effects

Objective: To explore the postoperative curative effects of patientswith temporal lobe epilepsy and whether had a relationship between thesurgical curative effect and the course of disease. Methods:183patients whohad undergone surgeries for temporal lobe epilepsy in the NeurosurgeryDepartment of Luzhou Medical College affiliated363Hospital form2002to2011were enrolled. The relevant information including of historycharacteristics, surgical programs, and more than two years outpatient orinformation of phone visiting. All patients routinely checked by1.5T head MRI,long-term video-EEG monitoring (VEEG) positioning epileptic foci, including45cases VEEG and MRI results are inconsistent because they can notaccurately located the starting area, Then accepted Subdural electrode andStereotactic depth electrodes monitoring to locate the main area of epilepsystarting side, which included of unilateral28cases, and7bilateral temporallobe epilepsy cases examined PET, Wada test. All the cases assessed byneurosurgery, neurology, electrophysiology, neuropathology, andneuropsychology expert working groups decide to surgery or not. Intraoperative cortical EEG monitoring was repeated used to clarify the location ofthe epileptic focus and extent of surgical resection. When intra operative monitoring showed abnormal discharge confined to temporal lobe performedstandard anterior temporal lobe resection, preoperation considered somepatients epileptic focus located medial temporal lobe, intraoperative monitoringfound epileptic foci has spread to the temporal lobe, performed temporal loberesection or/and hippocampus, amygdala, entorhinal cortex removal; Ifintraoperative monitoring epileptic foci is beyond the scope of the temporallobe, spread to the frontal pole, frontal lobe, parietal lobe, Removed temporallobe epileptic foci and outside temporal lobe epileptic foci; When lesionsspread to Ribbon taked intraoperative monitoring function and intraoperativewake-up technology to determine the functional areas, temporal lobe epilepticfoci resection and multiple cortical resection surgery or multiple lower heatburning soft film transection were performed., intraoperative cortical EEGmonitoring was repeated use until to the monitored area to normal cortical EEGwaveforms, the surgery was to end. All of patients from the hospital aftersurgery treated with antiepileptic drugs and adjusted by specialist.All patientswere followed up2-11years (average6.8years). According to the course isdivided into three groups length, early surgical treatment group (2-5yearsduration) in57cases, mid-surgery group (duration5-10years) in56cases,70cases of advanced surgical treatment group (over the course of10years). Thecurative effect different course of disease in postoperative patients wereanalysised according to Engel classification, and whether had some relationshipbetween the postoperative curative effect and the course of disease. All datawere analyzed using SPSS19.0software for statistical analysis, efficacy results after surgery using Kruskal-Wallis H rank sum test to compare three differentperiods. Measure of the mean standard deviation to describe, Correlationbetween the course and prognosis of surgical orderly classification as atwo-way information and Spearman rank correlation analysis using survivalanalysis. P <0.05was considered statistically significant. Results:183patientswere included in the study,The early surgical treatment group with seizure freerate was78.9%，which was significantly higher than the interim operationtreatment group，with no postoperative seizures accounted for67.9%and latesurgical treatment group，with seizure free rate of58.6%.There was statisticallysignificant difference between patients with different temporal lobe epilepsyduration and postoperative prognosis(P＜0.05), temporal lobe epilepsy courseand postoperative effects negatively correlated (r=-0.200, P=0.003), thelonger the duration, the efficacy worse. Conclusion: Early surgical interventionmay be more beneficial to control temporal lobe epilepsy and improve patient’s quality of life. The indications for surgery of temporal lobe epilepsy shouldconsider appropriate to relax, In particularly, when there is a clear prompt forMRI suggestive definite hippocampal sclerosis, VEEG spikes confined to oneside of the display front temporal lobe, temergence of drug-drug therapy early,should be undergo surgery as soon as possible.