Risk factors of seizure presentation in brain arteriovenous malformation patients and seizure outcomes after single-modality treatments.

BACKGROUND: Epileptic seizures are common symptoms in brain arteriovenous malformation patients and seizure control was an important issue in the treatments. This retrospective study attempted to define the risk factors of seizure presentation and to evaluate the effects of treatment modalities on seizure outcomes. METHODS: Patients receiving single treatment modality during 2013-2016 years, followed up more than 2 years were recruited. Logistic regression analysis was used to detect independent predictors. The factors associated with seizure control were analyzed in patients with pre-treatment seizures, and the factors associated with de novo seizures were analyzed in patents without pre-treatment seizures. RESULTS: Multivariate analysis identified that the independent predictors of seizure presentation were unruptured (ruptured vs. unruptured, OR = 0.314), and in the frontal (frontal vs. parietal, OR = 3.982) or temporal lobe (temporal vs parietal, OR = 3.313). In 47 patients with seizure presentation, good seizure outcomes were achieved in 26 cases. Partial obliteration of nidus (partial vs complete, OR = 32.301) and headache presentation were independent predictors of poor outcome. In 169 patients without seizure presentation, de novo seizures occurred in 22 cases. Treatments of microsurgery or radiosurgery led to a higher incidence of de novo seizures than intravascular embolization. CONCLUSIONS: Patients with unruptured and frontal/temporal lobe located nidus were more likely to manifest seizure presentation. Incomplete nidus obliteration was an independent risk factor of poor outcomes in patients with pre-existing seizures. However, compared to microsurgery or radiosurgery, endovascular embolization was less likely to cause de novo seizures in patients without pre-existing seizures.

An investigation on binocular summation response of visual evoked potential in children with hyperopia amblyopia / 眼科研究

Objective Conventional examination for vision function adopts subjective psychophysics methods.Pattern visual evoked potential (P-VEP) binocular summation response is a new objective way for the test of vision function.But its clinical value in evaluating vision function of amblyopia children is still in controversy.This study was to explore the binocular vision and the feature of P-VEP binocular summation in children with amblyopia and evaluate the significance of P-VEP binocular summation in binocular vision.MethodsThis is a case-controlled study.P-VEP binocular summation response and single ocular P-VEP response was respectively recorded in 151 hyperopia amblyopia children and 80 age- and gender-matched normal children.P-VEP response from children with hyperopia amblyopia was recorded under the corrected vision.The hyperopia amblyopia was diagnosed based on the standard of National Children Amblyopia and Strabismus Prevention and Treatment Working Group.The feature of P-VEP binocular summation was further analyzed and compared with monocular VEP response.Informed consent was obtained from each subject or custodian prior to the trail.ResultsNo significant difference was found in latency between P-VEP binocular summation response and monocular P-VEP response whether amblyopia children or normal children(P＞0.05).Binocular response/monocular response value in amblyopia children was lower than that in normal children(P＜0.05).Binocular response/monocular response value in mild or moderate amblyopia children was higher than that in severe amblyopia children(P＜0.05).Binocular response/monocular response value was significantly reduced in the children with binocular vision than in the children without binocular vision (P＜0.05).ConclusionP-VEP binocular vision,acting as an evaluation factor,could impartially reflect the function of binocular vision of amblyopia children.