J Korean Neurol Assoc > Volume 21(1); 2003 > Article

Journal of the Korean Neurological Association 2003;21(1): 46-53.

"내측측두엽간질 환자에서 전측두엽절제술의 예후인자:다변인 분석"

정상욱 , 윤창호 남현우 이상건

서울대학교 의과대학 신경과학교실,임상의학연구소

"Prognostic Factors in Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy: Multivariate Analysis"

Sang-Wuk Jeong

"Department of Neurology and Clinical Research Institute, Seoul National University College of Medicine"

Abstract

"Background : In order to identify the prognostic factors of anterior temporal lobectomy (ATL) for mesial temporal lobe epilepsy (TLE), we performed multivariate analyses in patients with mesial TLE. Methods : One hundred eighty six patients with mesial TLE (112 men and 74 women; mean age 28.9 ±8.7 years) were included. The primary outcome variable was a the patient ?s status in the third postoperative year: seizure free (except aura), or not. Clinical, electroen-cephalographic, radiological, intracarotid amobarbital test, and pathologic data were considered. Clinical data included age at surgery, age at nonfebrile seizure onset, duration of epilepsy, sex, seizure frequency, secondary generalization, history of febrile seizure, and existence of aura. Results : One hundred fifty eight patients (84.9%) had remission of seizure. Univariate analysis found age at surgery (p=0.006) and MRI abnormality including hippocampal sclerosis ipsi-lateral to surgery (p=0.01) to be significant. Multivariate analyses using logistic regressions, the younger age at surgery (p=0.002) and MRI lateralization (p=0.02) were found to be the significant predictors for good surgical outcome. Conclusions : Age at surgery and hippocampal findings on MRI are independent prognostic factors for ATL in mesial TLE. These findings suggest that mesial TLE is a progressive disorder and surgical outcome is better when early ATL is performed, at least in medically intractable cases.Key Words : Anterior temporal lobectomy, Mesial temporal lobe epilepsy, Prognostic factors"