Abstract: Objective To investigate the surgical outcome and its predictors in patients with cerebral cavernous malformation (CCM)-related epilepsy. Methods Patients with CCM-related epilepsy (CRE) who underwent resective surgery at our epilepsy center from January 2012 to December 2021 were collected,and their demographic and clinical data were retrospectively analyzed to identify potential predictors of surgical outcome using univariate analysis and multivariable logistic regression analysis. Results A total of 71 patients with CRE were included.Postoperative outcome was graded according to Engel class:78.9% (56/71) as Engel class I;21.1% (15/71) as Engel class II-IV,with a mean follow-up of 71.7±35.2 months (12~124 months).Univariate analysis showed that epilepsy duration,distribution of interictal epileptiform discharges and seizure frequency were associated with surgical outcome,whereas the location and number of CCMs were not associated with outcome,and multivariable logistic regression analysis showed that only epilepsy duration was an independent predictor of postoperative outcome (OR=0.928,95% CI 0.861-0.999,P=0.046). Conclusion Patients with CRE have good long-term surgical outcomes with resective surgery,and short epilepsy duration independently predicts good surgical outcomes;therefore,early surgical treatment of patients with CRE is recommended.

Key words: Cerebral cavernous malformation, Epilepsy, Surgical outcome, Predictors

摘要： 目的 探讨颅内海绵状血管瘤(cerebral cavernous malformation,CCM)相关性癫痫患者手术治疗效果及术后疗效的预测因素。方法 收集我中心2012年1月至2021年12月进行切除性手术治疗的CCM相关性癫痫患者,回顾性分析其人口学和临床资料,采用单因素分析和多因素logistic回归分析来确定术后疗效的潜在预测因素。结果 共纳入71例CCM相关性癫痫患者,术后平均随访71.7±35.2个月(12~124个月),术后疗效按Engel分级为:78.9%(56/71)为EngelⅠ级;21.1%(15/71)为Engel Ⅱ-Ⅳ级。单因素分析显示癫痫病程、间期癫痫样放电分布及发作频率与术后疗效相关,而CCM的位置和数量和疗效无关,多因素logistic回归分析显示只有癫痫病程是术后疗效的独立预测因素(OR=0.928,95%CI 0.861-0.999,P=0.046)。结论 CCM相关性癫痫患者通过切除性手术可获得很好的长期控制疗效,短的癫痫病程可独立预测好的术后疗效,因此建议CCM相关性癫痫患者应尽早进行手术治疗。

关键词: 海绵状血管瘤, 癫痫, 手术疗效, 预测因素