哈格曼% 0期刊文章%安妮%基督教g .好% Johanna莉娜霍普夫Thilo卡尔本% %菲利普Grewe % T癫痫手术Extratemporal vs颞叶癫痫手术% B变化量和扣押的结果在1990年和2017% D R 10.1212 / WNL 2022%。0000000000200194 % J首页神经病学% P e1902-e1912 % V 98% N 19% X背景和目标extratemporal叶癫痫(exTLE)手术后癫痫发作的结果经常被比颞叶癫痫(框架)手术后穷,但是最近改善诊断和手术可能会改变这一点。我们的目的是分析那些将要动手术的变化和手术数量和癫痫患者手术后2年结果exTLE与框架。方法我们进行回顾性单中心队列研究,包括从伯特利presurgical-surgical-postsurgical数据库病人从1990年到2017年。我们使用逻辑回归分析影响因素的几率手术和手术后癫痫自由的可能性。结果我们与那些将要动手术评价包括3822例,其中有2404人随后接受手术。那些将要动手术exTLE在评估患者的比例在1990年至1993年间从41%上升到64% 2014 - 2017。手术的几率下降随着时间的推移(2003 - 2011年:比值比(或)0.50 (95% CI 0.36 - -0.70);2012 - 2017:0.24(可信区间0.17 - -0.35);参考:1990 - 2002)和患者exTLE框架比患者手术几率较低,但是这种差异随时间下降(exTLE框架vs 1990 - 2002: 0.14(可信区间0.09 - -0.20);2003 - 2011:0.32(可信区间0.24 - -0.44);2012 - 2017:0.46(可信区间0.34 - -0.63))。 Etiology, the side of the epileptogenic lesion, and invasive recordings influenced the odds for surgery. The most frequent reasons for not undergoing surgery were missing identification of a circumscribed epileptogenic zone or an unacceptable risk of postsurgical deficits in patients with exTLE and the patient's decision in patients with TLE. Compared with patients with TLE, the odds for seizure freedom after surgery started lower for patients with exTLE in earlier years, but increased (≤2 lobes 1990–2002: OR 0.47 [CI 0.33–0.68]; 2003–2011: OR 0.62 [CI 0.44–0.87]; 2012–2017: OR 0.78 [CI 0.53–1.15]; ≥3 lobes 1990–2002: OR 0.37 [CI 0.22–0.62]; 2003–2011: OR 0.73 [CI 0.43–1.23]; 2012–2017: OR 1.46 [CI 0.91–2.42]). Etiology, age at surgery, and invasive recordings were further predictors for the odds for seizure freedom.Discussion Over the past 28 years, the success of resective surgery for patients with exTLE has improved. At the same time, the number of patients with exTLE being evaluated for surgery increased, as well as their odds for undergoing surgery.exTLE=extratemporal lobe epilepsy; EZ=epileptogenic zone; FCD=focal cortical dysplasia; GLM=generalized linear model; LEAT=low-grade epilepsy-associated tumor; MCD=malformation of cortical development (other than focal cortical dysplasia or diffuse hemispheric); MTS=medial temporal sclerosis; OR=odds ratio; TL=temporal lobe; TLE=temporal lobe epilepsy; TSC=tuberous sclerosis complex %U //www.ez-admanager.com/content/neurology/98/19/e1902.full.pdf