【摘要】 目的比较2011年国际抗癫痫联盟(ILAE)分类下颞叶局灶性脑皮层发育不良(focal cortical dysplasia,FCD)不同病理亚型的临床特征。方法回顾性分析2005-2011年在河北省人民医院功能神经外科进行颞叶癫痫手术患者241例。根据2011年ILAE分类对经过颞叶癫痫手术患者FCD按不同病理亚型进行分类,并对不同病理亚型患者癫痫发作起始年龄、患病年限、手术年龄、发作频率等临床特征进行分析,观察不同病理亚型患者的临床特征是否存在差异。结果 92例患者符合FCD诊断,结合型FCD平均发作起始年龄为19.2岁,晚于单纯型FCD(P=0.038)。在结合型FCD患者中,FCDⅢc型平均发作起始年龄为30.7岁,晚于结合型FCD中的其他亚型(P=0.007)。结合型FCD平均癫痫患病年限为7.8年,短于单纯型FCD(P=0.003)。在结合型FCD的病理亚型中,FCDⅢb型平均癫痫患病年限为3.5年(P=0.016),FCDⅢc型平均癫痫患病年限为5.3年(P=0.041),短于结合型FCD的其他病理亚型。FCDⅢc型平均手术年龄为35.8岁,晚于结合型FCD的其他病理亚型(P=0.014)。结论结合型FCD癫痫发作起始年龄晚,尤其是FCDⅢc型。结合型FCD手术前癫痫患病年限短,尤其是FCDⅢb型和FCDⅢc型。在结合型FCD患者中,FCDⅢc型平均手术年龄明显晚于结合型FCD的其他病理亚型。更多还原

【Abstract】 Objective To compare the clinical characteristics of different subtypes of focal cortical dysplasia( FCD) at human temporal lobe according to 2011 International League Against Epilespy( ILAE)classification. Methods Totally,241 cases of temporal lobe epilepsy were divided into different pathological subtypes of FCD according to 2011 ILAE classification. The clinical characteristics including epileptic seizure starting age,epilepsy duration,surgery age,seizure frequency,etc. were analyzed. Results Among 92 patients with FCD,the epileptic seizure average age of the associated FCD was 19. 2 years old,significantly older than that of the isolated FCD,with statistically significant difference( P = 0. 038). In the patients with associated FCD,the epileptic seizure average age of FCD Ⅲc was 30. 7 years old,significantly older than that of other subtypes of associated FCD( P = 0. 007). The average epilepsy duration of the associated FCD was7. 8 years,significantly shorter than that of the isolated FCD( P = 0. 003). In different pathological subtypes of the associated FCD,the epilepsy duration of FCD Ⅲb was 3. 5 years( P = 0. 016),and that of FCD IIIc was5. 3 years( P = 0. 041). Average surgery age of FCD Ⅲc was 35. 8 years old,significantly later than that of other subtypes of associated FCD( P = 0. 014). Conclusion The epileptic seizure average age of the associated FCD is late,especially FCD IIIc. The average epilepsy duration of the associated FCD is short,especially FCD IIIb and FCD IIIc. In the patients with associated FCD,the average surgery age of FCD IIIc is significantly later than that of other subtypes of associated FCD. The isolated FCD and associated FCD show different clinical characteristics.更多还原