The relationship of secondary epilepsy and craniocerebral operations:a clinical analysis of 186 cases / 解放军医学杂志

ABSTRACT

Objective To evaluate the clinical features in patients with pre- or post-operation epilepsy, and to explore the relationship of secondary epilepsy and craniocerebral operations. Methods The patients involved in present study were admitted and underwent the craniocerebral operations in the General Hospital of PLA from Jun.1999 to Feb.2008. The clinical data of epilepsy occurred at pre- or post-operation were retrospectively analyzed. All the 186 patients were divided into the pre-operation epilepsy group(Group A, n=90 ) and the post-operation epilepsy group(Group B, n=96). Based on a standardized questionnaire, a database was established with Microsoft Access 2007 including the primary etiological factor, the location of epileptogenic focus, the seizure frequency, the seizure type, and the abnormal electroencephalogram (EEG). Results Intracranial tumor and cerebrovascular malformation were the main primary etiological factors in group A, and intracranial tumor, cerebral trauma, cerebrovascular malformation and acute cerebral apoplexy were the main primary etiological factors in group B. The four main primary etiological factors for seizures were discovered in significant difference between group A and group B(?2=45.857 3,P=0.000 0). Cranial computed tomography(CT) or nuclear magnetic resonance imaging(MRI) detected that the most locations of epileptogenic focus were in frontal lobe(31.8% in group A and 29.5% in group B), temporal lobe(30.7% in group A and 26.3% in group B), and parietal lobe(17.0% in group A and 24.2% in group B). The frequency of seizure was significantly decreased in group A(?2=11.313 3,P=0.010 1), and was increased in group B(?2=77.080 3,P=0.000 0). The quantity of abnormal EEG for focal epilepsy was significantly decreased in group A(?2=9.773 4,P=0.007 5), but the increasing quantity of abnormal EEG was not significant in group B(?2=4.366 0,P=0.112 7). No significant difference in seizure type was proved after the craniocerebral operations in group A(?2=0.214 3,P=0.643 4). Campared with the post-operation epilepsy group, the location of epileptogenic focus did not show significant distinction in the pre-operation epilepsy group(?2=1.772 2,P=0.777 6). Conclusions Craniocerebral operation is an effective therapy for the secondary epilepsy with certain epileptogenic focus, and it is one of the definite causes of secondary epilepsy.