Surgical Treatment And Prognostic Analysis Of Intractable Epilepsy With Non-lesional MRI

Objective:To analyze the factors affecting the clinical outcomes of surgical operation in patients of intractable epilepsy with non-lesional MRI.Method:We retrospectively analyzed surgical outcomes of 64 patients of intractable epilepsy with non-lesional MRI in The First Teaching Hospital of Xinjiang Medical University from June 2015 to June 2018.The study included 25 male and 39 female patients aged 23 to 51,with an average of 26.9±4.1 years.The course of the disease was 1 to 16 years,with an average of 10.1±6.0 years.64 patients routinely improved Preoperative video electroencephalogram(VEEG),Magnetic resonance imaging(MRI),Positron Emission Tomography(PET-CT),multidisciplinary(MDT)discussion,detailed and comprehensive preoperative evaluation,localization of epileptic foci and resection of epileptic foci were performed during operation combined with cortical electroencephalogram(EcoG)monitoring.All patients were followed up regularly after operation.Engel classification method was used to analyze the surgical effects.using statistical methods for data analysis.Result:By Engel standard,grade Iand II are considered good prognosis,grade III and IV are considered unsatisfactory results.There are 46 cases with Engel grading I and II,accounting for 72%.There are 18 cases with Engel grading III and IV,accounting for 28%.Conclusion: The surgical prognosis of patients with intractable epilepsy with non-lesional MRI is generally good,and the prognosis is related to the coincidence between ECoG monitoring range and PET-CT showing the location of the submetabolic range,the location of the cerebral lobe where the epileptogenic focus is caused,whether the epileptogenic focus is completely removed,postoperative pathology,and the frequency of preoperative seizures.