Clinical-EEG Characteristics Analysis Of 3.0TMRI-negative Adult Patients With Epilepsy

BackgroundEven with the 3.0TMRI scan,there are still some patients with epilepsy who can't find brain structure or metabolic abnormalities associated with their symptoms,collectively known as 3.0T MRI-negative epilepsy.At present,there is very little research on the etiology of 3.0T MRI-negative epilepsy,and its understanding is still not deep enough.There is still no more effective means for treatment.ObjectiveAnalyze and summarize the clinical and EEG features of 3.0 TMRI-negative adult patients with epilepsy,to provide a basis for improving the etiology of 3.0TMRI-negative adult patients with epilepsy.MethodsCollect and analyze epilepsy patients treated in outpatient and inpatient department of Neurology in China-Japan Union Hospital of Ji Lin University from September 2016 to January 2018.The age of these patients were >=16 years old,in accordance with the International Epilepsy Alliance 2014 diagnostic criteria for epilepsy and 3.0TMRI plain scan of head were normal epilepsy patients.All patients were followed by detailed medical history,including name,sex,age,starting age,past history,course of disease,aura,type of seizure,frequency of episodes,video EEG results,head imaging examination,the current anti-epileptic drugs and drug efficacy.To summarize and analyze the clinical and electroencephalographic features of 3.0TMRI-negative adult patients with epilepsy,and to explore the possible underlying causes of 3.0TMRI-negative adult epilepsy.Deepen its understanding and provide a basis for its etiological diagnosis.Results1.Clinical features: All ages could be onset,the average age of onset was middle-aged group was(18-60 years old)the most common,accounting for 64.18%;37.31% of the patients had the cause of the disease,among which the history of minor craniocerebral trauma was the most common;50.75% of patients had clear aura symptoms before onset,and the specific aura symptoms were significantly higher than non-specific aura symptoms.The seizure type was most common with focal origin at the age of 18-60 was mostly onset of bilateral tonic-clonic seizures;>60-year-old onset was mostly of focal onset impaired awareness,And the generalized origin at the age of 0-17 was the most common;82.10% of patients were treated with standardized AEDs,and the effective rate was 67.27%;68.18% of them were monotherapy,with a total effective rate of 54.54%.2.EEG features: The positive rate of epilepsy detected by video-EEG was 62.69%.Intermittent abnormal discharges were most common in the temporal region,accounting for 40.48%,and were mostly confined to one side.Conclusion1.The age of onset of 3.0TMRI-negative epilepsy was more common in young and middle-aged patients,and the course of disease was short.Most of the patients were focal origin,and progression of bilateral tonic-clonic seizures as the main form of seizures,the highest proportion was temporal lobe epilepsy.AEDs treatment was still the main treatment for 3.0TMRI-negative epilepsy.2.Long-term VEEG was of great value in clinical diagnosis and localization of epileptogenic focus in patients with 3.0TMRI-negative epilepsy.3.3.0TMRI-negative adult epilepsy is mostly cryptogenic epilepsy.Immunization and multimodal imaging should be improved as soon as possible,and regular anti-epileptic treatment should be used to find the cause of intervention.