neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-3-23-29neurosurgery-1073Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTОтдаленные результаты лечения фармакорезистентных форм височной эпилепсииLong-term results of treatment of pharmacoresistant temporal lobe epilepsyhttps://orcid.org/0000-0001-5256-0905КрыловВ. В.KrylovV. V.

127473 Москва, ул. Делегатская, 20, стр. 1,

129090 Москва, Большая Сухаревская пл., 3

Bld. 1, 20 Delegatskaya St., Moscow 127473,

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0002-1170-6127ГехтА. Б.GekhtA. B.

115419 Москва, ул. Донская, 43

43 Donskaya St., Moscow 115419

https://orcid.org/0000-0002-6911-0975ТрифоновИ. С.TrifonovI. S.

127473 Москва, ул. Делегатская, 20, стр. 1

Bld. 1, 20 Delegatskaya St., Moscow 127473

https://orcid.org/0000-0003-0432-2915КордонскаяО. О.KordonskayaO. O.

Ольга Олеговна Кордонская

129090 Москва, Большая Сухаревская пл., 3,

117977 Москва, ул. Островитянова, 1, стр. 10

Olga O. Kordonskaya

3 Bolshaya Sukharevskaya Sq., Moscow 129090,

Bld. 10, 1 Ostrovityanova St., Moscow 117977

dr.kordonskaya@gmail.comhttps://orcid.org/0000-0001-5026-0060СинкинМ. В.SinkinM. V.

127473 Москва, ул. Делегатская, 20, стр. 1,

129090 Москва, Большая Сухаревская пл., 3

Bld. 1, 20 Delegatskaya St., Moscow 127473,

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»РоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia; N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian FederationГБУЗ «Научно-практический психоневрологический центр им. З.П. Соловьева Департамента здравоохранения г. Москвы»РоссияZ.P. Solovyov Scientific and Practical Psychoneurological Center, Moscow Healthcare DepartmentRussian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»; ФГБУ «Федеральный центр мозга и нейротехнологий» ФМБА РоссииРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; Federal Center for Brain and Neurotechnology, Federal Medical and Biological Agency of RussiaRussian Federation2021241020212332329Copyright © Крылов В.В., Гехт А.Б., Трифонов И.С., Кордонская О.О., Синкин М.В., 20212021Крылов В.В., Гехт А.Б., Трифонов И.С., Кордонская О.О., Синкин М.В.Krylov V.V., Gekht A.B., Trifonov I.S., Kordonskaya O.O., Sinkin M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1073

Цель исследования – оценить отдаленные результаты хирургического лечения пациентов с фармакорезистентной височной эпилепсией.

Материалы и методы

Материалы и методы. Выполнен ретроспективный анализ исходов лечения пациентов с фармакорезистентной височной эпилепсией. По критериям включения и исключения было отобрано 96 пациентов. В 1‑ю группу вошли 49 оперированных пациентов с МР-позитивной формой эпилепсией, во 2‑ю группу – 47 оперированных пациентов с МР-негативной эпилепсией. Группу контроля составили 53 неоперированных пациента. Исходы хирургического лечения оценивали через 6, 12 и 24 мес.

Результаты

Результаты. Неблагоприятные исходы встречались чаще в группе неоперированных пациентов, чем в обеих группах оперированных пациентов (р <0,001). Вероятность достижения двухлетней ремиссии после вмешательства у оперированных пациентов при наличии очага по данным магнитно-резонансной томографии (МРТ) достигала 60 %, при отсутствии очага на МРТ – 45 %, а у неоперированных пациентов – только 2 %. Средняя длительность бесприступного течения заболевания была наибольшей у оперированных пациентов с выявленным по данным МРТ патологическим очагом (15,4 ± 1,5 мес), а наименьшей – у неоперированной группы (3,3 ± 0,9 мес).

Заключение

Заключение. Представленные результаты доказывают эффективность и безопасность хирургического лечения пациентов с фармакорезистентной височной эпилепсией. 

The aim of the study wasto evaluate the long-term results ofsurgicaltreatment of patients with pharmacoresistant epilepsy.

Materials and methods

Materials and methods. A retrospective analysis of treatment outcomes in patients with drug-resistant temporal lobe epilepsy was performed. According to the inclusion and exclusion criteria, 96 patients were selected for the study. Group 1 contained 49 operated patients with MR-positive epilepsy and Group 2 contained 47 operated patients with MR-ne‑ gative epilepsy. The control group consisted of 53 unoperated patients. The outcomes ofsurgical treatment were assessed after 6, 12, and 24 months. Results. Unfavorable outcomes occurred more frequently among nonoperated patients compared to both surgical groups (p <0.001). The probability of the 2-year remission after surgery in operated MRI positive patients was 60 %, in MRI negative group was 45 %, and in conservative group – only 2 %. The mean duration of the seizures-free period was greatest̆in the MRI positive surgical group (15.4 ± 1.5 months), and shortest in the control group (3.3 ± 0.9 months).

Conclusion

Conclusion. The presented results prove the effectiveness and safety of surgical treatment of patients with temporal lobe epilepsy.

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The authors declare that there are no conflicts of interest present.