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• W3048259580 abstract "Objective: To summarize the clinicopathological characteristics of difficult to locate intractable epilepsy patients, and investigate the causes of difficulty in their location. Method: Retrospective analysis was performed on the clinical data of 58 patients who underwent resection of the epileptogenic zones after intracranial electroencephalography (iEEG) detection at the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from January 2010 to December 2018. Clinicopathological characteristics and lesion lobes of difficult to locate intractable epilepsy were summarized. The prognosis of patients was assessed according to Engel grading.Univariate and multivariate logistic regression analysis were used to investigate the relevant factors affecting the prognosis of patients with difficult to locate intractable epilepsy related to malformation of cortical development(MCD). Results: Among the 58 patients, there were 47 cases of MCD (12 cases with mild malformation of cortical development (mMCD), 35 cases with focal cortical dysplasia (FCD)), and 11 cases of other types. Among the 47 MCD cases, univariate analysis showed that patients with preoperative magnetic resonance imaging(MRI) positive and completed resection of the epileptogenic zones had better prognosis (P<0.05). Multivariate analysis indicated that completed resection of epileptogenic zones was an independent factor affecting the postoperative efficacy of MCD (P=0.013,Wald χ(2)=6.149, 95%CI: 0.07-0.56). And among the 47 MCD cases, 18 cases were with mono-lobar lesions and 29 cases were with multi-lobar lesions, however, there was no significant difference of the efficacy between the two groups (P=0.511). Conclusions: MCD, especially FCD, is the main pathological types of patients with difficult to locate intractable epilepsy. Multi-lobar pathological changes, especially multi-lobar MCD, are the main reasons of being difficult to locate, however, accurate locating of epileptogenic zones and functional areas via effective use of iEEG can achieve satisfactory efficacy in these patients after resection of the epileptogenic zones.目的： 总结难定位难治性癫痫患者的临床病理类型特点，并探讨其较难定位的原因。 方法： 回顾性分析2010年1月至2018年12月于福建医科大学附属第一医院神经外科经侵袭性颅内脑电图（iEEG）监测后行致痫灶切除的58例患者的临床资料，总结难定位难治性癫痫患者的临床病理类型特点及病变脑叶，根据Engel分级评估患者预后，使用单因素分析和多因素Logistic回归分析探讨影响皮质发育不良（MCD）相关难定位难治性癫痫的预后的相关因素。 结果： 58例中，MCD 47例[轻微皮质发育不良（mMCD）12例，局灶性皮质发育不良（FCD）35例]，其他11例；MCD中，通过单因素分析发现术前磁共振阳性、致痫灶完全切除的患者预后更佳（P<0.05），多因素分析发现致痫灶完全切除是影响MCD术后疗效的独立影响因素（P=0.013，Wald χ(2)=6.149,95%CI 0.07~0.56）；MCD中，18例为单脑叶病变，29例为多脑叶病变，两组在疗效上的差异无统计学意义（P=0.511）。 结论： MCD尤其是FCD是难定位难治性癫痫的主要病理类型；多脑叶病理改变尤其是多脑叶MCD是导致难定位难治性癫痫较难定位致痫灶的主要原因，而通过有效使用iEEG精确定位致痫灶及功能区可使多数该类患者在致痫灶切除术后获得满意疗效。." @default.
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• W3048259580 date "2020-08-04" @default.
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• W3048259580 title "[Clinicopathologic characteristics and causes of difficulty in locating the difficult to locate intractable epilepsy]." @default.
• W3048259580 doi "https://doi.org/10.3760/cma.j.cn112137-20191115-02481" @default.
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