摘要
目的探讨难治性颞叶癫痫(temporal lobe epilepsy,TLE)患者继发双侧强直-阵挛发作(bilateral tonic-clonic seizure,biTCS)的发生率和风险因素。方法连续性收集2012年1月-2018年12月期间在我院癫痫中心接受切除性手术治疗的TLE患者数据,并回顾性分析其人口学和临床特征,采用单因素分析和多因素Logistic回归分析来确定biTCS的潜在风险因素。结果本研究共纳入397例患者,70.0%(278/397)的患者有biTCS发生。单因素分析显示癫痫病程和MRI与TLE患者biTCS的发生有关(P<0.05),多因素Logistic回归分析显示癫痫病程(OR=1.13,95%CI 1.09~1.18,P<0.001)和发作先兆(OR=0.51,95%CI 0.31~0.85,P=0.009)是TLE患者biTCS的独立危险因素。癫痫病程预测TLE患者biTCS的受试者操作特征(ROC)曲线下面积(AUC)为0.74,截断值为9.5年(敏感性:66.5%,特异性:75.6%)。结论大部分难治性TLE患者在病程中会出现biTCS,没有发作先兆和长的癫痫病程可独立预测biTCS的发生。
Objective To investigate the occurrence and risk factors of secondary bilateral tonic-clonic seizure(biTCS)in patients with refractory temporal lobe epilepsy(TLE).Methods Data on TLE patients who underwent resective surgical treatment at our epilepsy center,between January 2012 and December 2018,were collected consecutively,and their demographic and clinical characteristics were retrospectively analyzed to determine potential risk factors for biTCS using univariate analysis and multifactorial logistic regression analysis.Results A total of 397 patients were included in this study,and 70.0%(278/397)of them had biTCS.Univariate analysis showed that epilepsy duration and MRI were associated with the occurrence of biTCS in patients with TLE(P<0.05),and multifactorial logistic regression analysis showed that epilepsy duration(OR=1.13,95%CI 1.09-1.18,P<0.001)and aura(OR=0.51,95%CI 0.31-0.85,P=0.009)were independent risk factors for biTCS in refractory TLE patients.Receiver operating characteristic(ROC)analysis showed that the area under the curve(AUC)of the epilepsy duration for biTCS in TLE patients was 0.74 with a cut-off value of 9.5 years(sensitivity:66.5%,specificity:75.6%).Conclusion Most patients with refractory TLE develop biTCS during the course of the disease,and absence of aura and long epilepsy duration independently predict the occurrence of biTCS.
作者
马炜
陈隆
张伟
高立
MA Wei;CHEN Long;ZHANG Wei(Department of Neurosurgery,Tangdu Hospital,Air Force Military Medical University,Xi'an 710038,China)
出处
《中风与神经疾病杂志》
CAS
2023年第1期52-55,共4页
Journal of Apoplexy and Nervous Diseases
关键词
颞叶癫痫
双侧强直-阵挛发作
病程
发作先兆
风险因素
Temporal lobe epilepsy
Bilateral tonic-clonic seizure
Epilepsy duration
Aura
Risk factors
