目的:已发现卵圆孔未闭(PFO)的闭合手术可有效控制隐源性中风和偏头痛,但不确定PFO封堵是否也能缓解癫痫发作。本研究旨在观察PFO封堵术对癫痫发作的治疗效果。
方法:自7月11日起,2017年,在华西医院神经内科,四川大学,成都,我们一直定期对接受PFO封堵术的癫痫患者进行监测.患者的临床信息,比如频率,持续时间,以及癫痫发作的严重程度,详细记录手术前后以及术后安全事件.
结果:在31例确诊PFO的癫痫患者中(27例为耐药性癫痫,87.10%),手术平均年龄为23.74岁,女性12例(38.71%)。经过一年的随访,26例患者(83.87%)实现了癫痫发作频率的缓解,其中22人(70.97%)的缓解率超过50%。此外,与手术前相比,22例(70.97%)报告平均癫痫发作持续时间减少,20例(64.52%)报告癫痫发作严重程度降低。在发作频率指标中,平均持续时间和严重程度,术前和术后比较存在显著差异,所有检验p值均<0.05.此外,除一名短暂报告胸痛的患者外,未报告严重的安全事件,所有患者均表示有效的PFO闭合。
结论:PFO闭合首次被证明导致频率显着降低,持续时间,以及癫痫发作的严重程度。耐药性癫痫和大分流PFO的患者是进行PFO闭合的理想人选。
结论:由于发现PFO封堵术对隐源性中风和偏头痛有良好的治疗效果,它已成为治疗神经系统疾病的可靠补充疗法,而伴有PFO的耐药癫痫有望成为下一个PFO封堵术可显著改善的目标疾病。
OBJECTIVE: Closure surgery of patent foramen ovale (PFO) has been found to effectively control cryptogenic stroke and migraine, but it is uncertain whether PFO closure could also alleviate epileptic seizures. This study aims to observe the therapeutic effect of PFO closure on epileptic seizures.
METHODS: Since July 11th, 2017, in the neurology department of West China Hospital, Sichuan University, Chengdu, we have been regularly monitoring patients with epilepsy who have undergone PFO closure. The patient\'s clinical information, such as frequency, duration, and severity of seizures, before and after surgery was recorded in detail as well as postoperative safety events.
RESULTS: Of the 31 epilepsy patients who confirmed PFO observed (27 cases were drug-resistant epilepsy, 87.10%), average age of surgery was 23.74 years, and 12 cases were female (38.71%). After one-year follow-up, 26 patients (83.87%) achieved remission of seizure frequency, and 22 of whom (70.97%) experienced a remission of more than 50%. Additionally, compared to before surgery, 22 cases (70.97%) reported a decrease in the average seizure duration, and 20 cases (64.52%) reported a reduction in seizure severity. In the seizure indicators of frequency, average duration and severity, significant differences were identified between preoperative and postoperative comparisons with all test p values were <0.05. Furthermore, no serious safety events were reported except for one patient who briefly reported chest pain, and all patients expressed effective PFO closure.
CONCLUSIONS: The PFO closure has been shown for the first time to result in a significant reduction in the frequency, duration, and severity of seizures. Patients with drug-resistant epilepsy and PFO with a large shunt are ideal candidates for undergoing PFO closure.
CONCLUSIONS: Since PFO closure was found to have a good therapeutic effect on cryptogenic stroke and migraine, it has become a credible complementary therapy for the treatment of neurological diseases, and drug-resistant epilepsy with PFO is expected to become the next target disease that PFO closure could significantly improve.