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J Korean Neurol Assoc. 2008;26(2):104-109.
- Clinical Factors Related With Response to Anti-epileptics in Temporal Lobe Epilepsy With Hippocampal Sclerosis
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Hyun-Woo Yang
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Department of Neurology, Neurosurgerya, and Pediatricsb, Inje University College of Medicine, Busan, Korea
- 해마경화증을 동반한 측두엽 간질에서 항경련제에 대한 반응성과 관련된 임상적 요인
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양현우, 이 웅 정용태a 황태규b 김성은
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인제대학교 의과대학 부산백병원 신경과학교실, 인제의대 신경외과학교실a, 인제의대 소아과학교실b
- Abstract
- Background
s: Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is not always intractable to antiepileptic drugs (AEDs). To identify the responsiveness to AEDs and related clinical factors in TLE-HS, we performed this study.
Methods
Consecutive 100 (51 men, mean age=30.2±6.6, age range=19-50) patients with TLE-HS were divided into two groups by their responsiveness to AEDs. Intractable TLE-HS was defined if they had any seizures for the preceding year with at least two AEDs. Clinical factors were analyzed to find the association of the responsiveness to AEDs.
Results
Intractable TLE-HS was found in 68% of patients. The younger age of onset (12±4 vs. 31±8 years, p<0.0001), longer duration of epilepsy (17±6 vs. 2±1 years, p<0.0001), more than five tonic-clonic seizures (GTCs) with secondary generalization (29.4 vs. 6.3%, p=0.0009) and bilateral epileptiform abnormalities on EEG (30.9 vs 6.3%, p=0.0054) were significantly correlated with the intractable TLE-HS. According to multiple logistic regression analysis, bilateral epileptiform abnormalities on EEG (adjusted OR=9.4, 95% CI: 1.98~44.76) and more than five GTC (adjusted OR=7.7, 95% CI: 1.60~33.39) were independently related with poor responsiveness to AEDs in TLE-HS.
Conclusions
The presence of hippocampal sclerosis does not necessarily mean intractability to AEDs. The clinical variables related with the poor response to ADEs in TLE-HS are more than five GTCs and bilateral epileptiform abnormalities on EEG.KeyWords:Hippocampal sclerosis, Temporal lobe epilepsy, Pharmacoresistance
Keywords :
- 초록
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