Preoperative Evaluation Of Drug-resistant Epilepsy And Analysis Of Influencing Factors

Objective:To understand the evaluation effect of VEEG,MRI and PET-CT on the surgical treatment of medicated refractory epilepsy,and to explore the factors affecting the surgical efficacy.Method:(1)Review the clinical data of 114 patients with medically refractory epilepsy who received surgical treatment in the department of neurology and surgery of the first affiliated hospital of XinJiang Medical University from January 2016 to June 2019.(2)For 76 of them,VEEG,head MRI and head PET-CT were completed before operation,and the positive rates of the three examination methods were compared;The consistency of MRI and VEEG,MRI and PET-CT,and VEEG and PET-CT were compared.(3)All patients were followed up for 3 months to 3 years to observe the surgical effect.To analyze the factors affecting the curative effect of medicated refractory epilepsy surgery.Results:(1)The highest rate of VEEG,MRI and PET-CT preoperative examination results was PET-CT(81.57%),the consistency rate of PET-CT and VEEG was 80.26%,that of PET-CT and MRI was 75.00%,and that of MRI and VEEG was 64.47%.(2)Single factor shows that the number of 24-hour video EEG discharge sites(intermittent discharge),surgical resection mode and postoperative pathology,age of onset,course of disease and weekly frequency of attacks before surgery have a significant correlation with surgical efficacy.Multiariable Logistic regression analysis showed that the 24 hours of video electroencephalogram(EEG)discharge part number(intermittent discharge),preoperative seizure frequency per week to influence the treatment effect of the independent risk factors(P<0.05),resection of the temporal lobe,hippocampus and the amygdala as control group,the operation line of Logistic back analysis found that the frontal lobe resection group curative effect is relatively poor.Conclusion:(1)The sensitivity of PET-CT to the localization of epileptic lesions was higher than that of MRI and VEEG,and the detection rate of PET-CT and VEEG was higher than that of MRI and VEEG.(2)The number of discharge sites of 24-hour VEEG(intermittent discharge)and thefrequency of weekly attacks before the operation were related to the postoperative efficacy.The temporal lobe+hippocampus+amygdala resection group had a good effect,while the frontal lobe epilepsy resection group had a poor effect.