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해마경화증을 동반한 측두엽 간질에서 항경련제에 대한 반응성과 관련된 임상적 요인

Clinical Factors Related With Response to Anti-epileptics in Temporal Lobe Epilepsy With Hippocampal Sclerosis

정용태|황태규|김성은|이웅|양현우
대한신경과학회 (Korean Neurological Association)|2008.05|대한신경과학회지 (Journal of the Korean Neurological Association)|제26권 제2호|pp. 104-109

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참고문헌

키워드

Temporal lobe epilepsyHippocampal sclerosisPharmacoresistance
주제분류신경과학

초록

Backgrounds: 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.

Abstract

Backgrounds: 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.

참고문헌 (35)

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