Influence of relapse of medically intractable temporal lobe epilepsy shortly after surgery in its long-term efficacy

Abstract

Objective To investigate the influence of drug refractory temporal lobe epilepsy relapse shortly after surgery in its long-term efficacy.Methods The clinical data of 57 patients with medically intractable temporal lobe epilepsy,underwent surgery from August 2010 to August 2011 in our hospital,were retrospectively analyzed; all the patients were performed surgery,and postoperative treatment of epilepsy (adjustment antiepileptic drugs) in our hospital and rehabilitation center was chosen;the parallel regular follow-up clinic or telephone was also performed.According to the relapse situation one year after surgery,these patients were divided into control group (no epilepsy,n=18) and experimental group (relapse,n=39).Follow-up data,long-term efficacy and overall efficacy between the two groups were analyzed.Results (1) Postoperative medial temporal lobe sclerosis,neoplastic lesions,mixed lesions and normal patients were 27,7,10 and 13,respectively,counting for 47.37％,12.28％,17.54％ and 22.81％ of the patients; (2) on the second year of surgery,patients in the experimental group had 44.44％ satisfactory seizure control,which was significantly lower than those in the control group (74.36％,x2=4.839,P=0.028); (3) Kapan-Meier survival curve indicated that epilepsy remission rate in the control group was significantly higher than that in the experimental group on the second year of surgery (x2=5.928,P=0.017); (4) multivariate Logistic regression analysis showed that risk factors affecting the long-term efficacy included incentives recurrence (OR=4.511,95％CI:3.195-7.569),relapse frequency≥ 3 times (OR=4.281,95％CI:0.040-0.712) and recurrence of epilepsy type to complex partial seizure/generalized tonic-clonic seizures (OR=3.344,95％CI:3.186-8.400).Conclusion Drug refractory temporal lobe epilepsy relapse shortly after surgery will affect its long-term efficacy,and the determinate factors included incentives recurrence,relapse frequency≥ 3 times and recurrence of epilepsy type. Key words: Temporal lobe epilepsy; Relapse; Long-term efficacy