Analysis Of The Predictive Factor For Prognosis Following Surgery For Temple Lobe Epilepsy

Objective：To investigate the outcome of temporal lobe epilepsysurgery and identify the variables which predict the prognosis withrespect to seizures in postoperative follow-up after one and three years.Methods：93Patients who was diagnosed drug-resistant templelobe epilepsy and had temporal epileptogenic opration between April2003and April2012was followed up about one, three,five and eightyear prognosis.We Performed a retrospective consecutive analysis aboutgender,age of onset,course,age of opration,seizure frequency,seizureforms, past history,aura, epilepsy protocol magnetic resonance imaging(MRI), long-term video-electroencephalography(video-EEG),intracranial electrode implantations,oprationstrategy,operation side, APOS, seizure in the first6months aftersurgery,pathology and the video-electroencephalography afteroperation.Seizure outcome was classified into good prognostic group（EngelⅠ+EngelⅡ）and bad prognostic group（EngelⅢ+EngelⅣ）according to Engel’s classification. Logistic regression analysis wasundertaken to identify which variables were associated with theprognosis in the postoperative follow-up of seizure status.Result：There were93patients in our cohort study,including42female and51male,no patient was lost follow-up;mean follow-up was3.6years.In the first year after operation,there were85patients had goodprognosis （91.4%） and73patients had seizure free（78.5%）;Univariate logistic regression analysis show that patients who had two ormore seizure forms,Unilateral ictal location and no seizure in the first6months after surgery will have the good prognosis;However multivariatelogistic regression find that Unilateral ictal location, APOS and seizure in the first6months after surgery was the Independent predictors. In thethird year after operation,68patients was followed-up,there were61patients had good prognosis （89.7%） and54patients had seizure free（79.4%）; Univariate logistic regression analysis show that patientswho have only one seizure form, Unilateral ictal location, no seizure inthe first6months after surgery, un-specificness pathological finding,HS,dual pathology will have good prognosis;but multivariate logisticregression show no special independent predictors. In the fifth year afteroperation,31patients was followed-up,all patients had good prognosis（100%） and28patients had seizure free（90.3%）.In the eighthyear,there were9patients was included,all patients had good prognosis(100%) and8patients were seizure free (88.9%).Conclusion: APOS and seizure in the first6months after surgerywas the independent predictors of the first year after surgery;we didn’tfind any factors predict the future Independently at the point of the thirdyear after surgery.