手术对性-克隆性发作的影响
Juan Luis Alcala-Zermeno1,2, Marina Romozzi1,3, Michael R Sperling1
1Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Epilepsia
|January 4, 2025
概括
手术显著减少或消除焦点到双边强力克隆性发作 (BTCS),改善患者的治疗结果. 这表明,即使在没有完全实现发作自由的情况下,手术也是有益的,这凸显了需要新的结果措施的必要性.
科学领域:
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
- 临床神经学 临床神经学
背景情况:
- 手术的结果通常通过整体发作减少来评估,而忽略了特定的发作类型,如焦点到双边强力-克隆性发作 (BTCS).
- BTCS与显著的发病率和死亡率有关,使得它们在手术后的具体结果对患者的福祉至关重要.
研究的目的:
- 评估手术后焦点至双边强力克隆性 (BTCS) 停止的频率.
- 为了确定手术后新出现BTCS的发生率.
主要方法:
- 对前手术数据库的分析 (1986-2022年).
- 根据手术前BTCS的存在和活性对患者进行分层.
- 在切除性手术后的BTCS负担和自由率的表征.
主要成果:
- 在521名手术前BTCS患者中,58%的患者经历了手术后的停止,持续BTCS患者的频率中位数减少了92%.
- 在283名没有手术前BTCS的患者中,De novoBTCS发生在6%的患者中.
- 在所有患者中,有72%的患者在≥1年内实现了无发作,而没有手术前BTCS (47%) 的患者的发作率高于手术前BTCS (33%) 的患者.
结论:
- 手术在减少或消除BTCS方面表现出明显的有效性,可能降低相关的发病率和死亡率.
- 这些发现支持提供手术,即使完全无发作并不是最可能的结果.
- 需要修订的外科结果尺度,包括减轻发作的严重程度,特别是BTCS.
关键词:
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