| Objective: By summarizing the clinical and EEG characteristics of183 patients with 3.0T epilepsy sequence MRI-negative epilepsy,and analyzing the relevant factors affecting the prognosis and exploring the potential etiology,we aim to further improve our knowledge and understanding of seizure sequence MRI-negative epilepsy and provide a reference basis for clinical diagnosis and treatment.Methods: The clinical data of 183 patients with seizure sequence MRI-negative epilepsy who attended the Affiliated Hospital of Jining Medical College from June 2016 to June 2021 were retrospectively analyzed,and the patients’ gender,initial precipitating events,age of onset,seizure form and frequency,EEG,family history of epilepsy,and history of antiepileptic drug use were compiled and recorded,their clinical characteristics were summarized,and they were divided into two groups with good prognosis and poor prognosis,and the influence of the above factors on prognosis was explored using one-way and multi-way Logistic regression analysis.Results: 1.There were 183 patients included in the study,of whom87(47.54%)were men and 96(52.46%)were women;the age of onset was 5-69 years,with a mean age of onset of(30.43±18.37)years,of which 56.28% were young and middle-aged;130(71.04%)patients had a disease duration of less than 5 years.2.Forty-three patients(23.50%)had a previous history of epilepsy,including 5 cases(2.73%)with history of head trauma,6 cases(3.28%)with history of intracranial infection,7 cases(3.83%)with history of perinatal injury,7 cases(3.83%)with family history of epilepsy,9 cases(4.92%)with history of febrile convulsion and 9 cases(4.92%)with history of paroxysmal headache.3.Seizures of focal origin were the most common type of seizures(126 cases,68.85%),of which 87 cases(47.54%)were focal progression to bilateral tonic-clonic seizures.4.Epileptic discharges were found in 134 patients.The detection rate was 73.22%.The temporal area was the most common site of epileptic discharges,accounting for 36.57%.5.165 patients(90.16%)were treated with standardized AEDs,of which 107 patients(68.85%)were treated with monotherapy.Forty-five patients(27.27%)were treated with two AEDs,and 13 patients(7.88%)were treated with three AEDs.Among 165 patients with standardized AEDs treatment,17.49% were completely controlled,26.23% were markedly effective,23.50% were effective,36.36% were ineffective.The total effective rate was 63.63%.6.Univariate Logistic regression analysis showed that the course of disease,seizure type,past history,seizure frequency,EEG and drug treatment were statistically significant for the prognosis of magnetic resonance imaging negative epilepsy(P<0.05).Multivariate Logistic regression analysis showed that frequent seizures(OR=4.907,P<0.001)and abnormal EEG(OR=8.165,P=0.046)were independent risk factors for poor prognosis.Conclusion: The onset age of epilepsy with negative MRI sequences was mostly young and middle-aged,and short time course.Focal seizures and focal progression to bilateral tonic-clonic seizures were the main seizure types.AEDs is the main treatment method,and monotherapy is effective.High seizure frequency and abnormal EEG are independent risk factors for poor prognosis. |
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