海绵状血管畸形与癫痫的研究课件

《海绵状血管畸形与癫痫的研究课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Surgicalmanagementandlong-termseizureoutcomeafterepilepsysurgeryfordifferenttypesofepilepsyassociatedwithcerebralcavernousmalformationsPreciseoutcomedataaboutthesurgicaltherapyofcerebralcavernousmalformation(CCM)–associatedepilepsyisscarceregardingdifferentepil

2、epsytypes,surgicalapproach,andoutcome.Long-termoutcomeinpatientswithCCM-associatedepilepsyisanalyzedinalargesingle-centerseries.PurposeMethodsSeizureoutcomedata>24monthswasavailablein118patients.Theinfluenceofdifferentparametersofpreoperativeworkupandsurgicaltech

3、niquewasanalyzedwithregardtoseizureoutcome.KeyFindingsdrug-resistantepilepsy(DRE),76例chronicepilepsy20例sporadicseizures22例TemporallocalizationofCCMpredisposedtodevelopDRE.Detailedepileptologicworkupwasperformedin85patients;invasivemonitoringwasdonein23(37%)of76DR

4、Ecases.Meanfollow-upvariedbetween107and137monthsforthethreegroups.Seizurefreedom；inDREwas88%,inchronicepilepsy80%,insporadicseizureswas91%.Longersymptomdurationwasassociatedwithworseseizureoutcome.SignificanceSurgicaltherapyofCCM-associatedseizuresandepilepsycanb

5、esuccessfulifdifferentsurgicaltechniquesaccordingtopresurgicalevaluationarerealized.TopreventclinicalworseningintoDRE,surgicalinterventioninCCM-associatedepilepsymaybeconsideredearly.发病率等CerebralcavernousMalformations(CCMs)accountfor10–15%ofallvascularmalformatio

6、nsintheadultbrain(Batraetal.,2009).TheincidenceofCCMsisthoughttorangebetween0.4%and0.8%(DelCurlingetal.,1991).Fortypercentto70%ofpatientswhohavesupratentorialCCMpresentwithepilepsy(Awad&Jabbour,2006;Ferrieretal.,2007).发病率Seizuresmostprobablyresultfromvariouseffec

7、tsofbloodbreakdownproductsintheperilesionalcorticalarea。TheepileptogenicityofCCMisinfluencedbyitslocalization,particularlyarchicorticalortemporallobelocalization(Menzleretal.,2010).PatientswithsymptomaticCCMmaypresentclinicallywithoccasionalepilepticseizuresbutth

8、eymayalsoleadtochronicorevendrug-resistantepilepsy(DRE)inabout35–40%ofallcases(Kondziolkaetal.,1995;Porteretal.,1997;Changetal.,2009).Upto4%ofallDREpatientswer