论文部分内容阅读
目的回顾性分析伴海马硬化癫痫患者的临床资料,探讨热性惊厥与海马硬化的关系。方法 507例癫痫患者由MRI证实伴海马硬化。根据儿童期是否出现热性惊厥,将患者分为两组:即热性惊厥组(FS+组)和无热性惊厥组(FS-组),进一步将FS+组分为1岁以内亚组和1~5岁亚组。采用卡方检验和t检验对两组和两亚组在性别、非热性发作起始年龄、热性惊厥年龄与非热性发作间的间隔时间、海马硬化出现的单双侧以及是否实施癫痫手术等参数进行统计学比较。结果 507例患者中,热性惊厥史阳性者88例,占17.4%。癫痫非热性发作平均起病年龄FS+组明显低于FS-组[(10.5±6.4)岁vs.(15.7±10.8)岁,P=0.000]。实施手术治疗的比例FS+组稍多于FS-组[37例(42.0%)vs.135例(32.2%),P=0.051]。FS+组和FS-组及FS+亚组在性别、海马硬化的单双侧等参数比较无统计学差异。FS+亚组在非热性发作平均起病年龄、FS年龄与非热性发作间的间隔时间、是否实施手术等方面无统计学差异。FS+组接受手术治疗的患者病程明显长于药物治疗者[(8.1±4.4)年vs.(7.1±6.9)年,P=0.009]。手术治疗随访者中92.3%达EngelⅠ级。结论伴海马硬化的癫痫患者中儿童期出现热性惊厥史者,出现癫痫非热性发作的平均起病年龄明显早于无热性惊厥史的海马硬化癫痫患者;这部分患者可能进行癫痫手术治疗的预后更好。
Objective To retrospectively analyze the clinical data of hippocampal sclerosis patients with epilepsy and explore the relationship between febrile seizures and hippocampal sclerosis. Methods 507 patients with epilepsy were confirmed by MRI with hippocampal sclerosis. Patients were divided into two groups according to whether they had febrile seizures in childhood: the febrile seizure group (FS + group) and the febrile seizure group (FS- group). The FS + group was further divided into 1-year-old subgroup and 1 ~ 5 years old subgroup. The chi-square test and t-test were used to compare the age at onset of gender, non-febrile seizure, febrile seizure age and non-febrile seizure, unilateral and bilateral hippocampal sclerosis, and whether epilepsy Surgery and other parameters for statistical comparison. Results Of the 507 patients, 88 were positive for febrile seizures, accounting for 17.4%. The mean onset age of non-seizure seizures was significantly lower in the FS + group than in the FS-group [(10.5 ± 6.4) vs. (15.7 ± 10.8) years, P = 0.000]. The proportion of patients undergoing surgery was slightly higher in the FS + group than in the FS-group [37 (42.0%) vs 135 (32.2%), P = 0.051]. FS + group and FS- group and FS + subgroup in gender, hippocampal sclerosis unilateral and bilateral parameters no significant difference. There was no significant difference in the mean age at onset of non-thermal seizures, FS age and non-febrile seizures, whether or not to perform surgery in the FS + subgroup. Patients in the FS + group had a significantly longer duration of disease than those treated with the drug [(8.1 ± 4.4) years vs. (7.1 ± 6.9) years, P = 0.009]. Surgical treatment of follow-up in 92.3% of Engel Ⅰ level. Conclusion The history of febrile seizures in children with hippocampal sclerosis has a history of onset of onset of non-febrile epilepsy obviously earlier than that of hippocampal sclerosis patients with no history of febrile seizures. This part of patients may have epilepsy surgery The prognosis is better.