Discussion
PFO, seizures, epilepsy, seizure, PFO of high-grade RLS, migraines, epileptic, cryptogenic stroke
EPILEPTIC, MIGRAINES, EPILEPSY
The etiology of refractory epilepsy is complex and difficult to explore, and current drug therapies have not demonstrated satisfactory control efficacy. To the best of our knowledge, the PFOC-RE trial will be the first in the world to perform PFO closure in patients with refractory epilepsy accompanied by PFO of high-grade RLS and that covers at least a quarter of those with refractory epilepsy, which may bring encouraging news. This study aims to achieve good treatment effects in relieving epileptic symptoms in patients with refractory epilepsy and PFO, including reducing the frequency of postoperative seizures and alleviating seizure symptoms. However, there are still some limitations in this trial. Due to patients into the intervention group should undergo PFO closure, it is hard to effectively mask protocol for the patients and physicians, which may cause bias and may need to be verified in future real-world studies with larger samples.The mechanism of the impact of the PFO on brain neurofunction has been gradually clarified, and there is enough clinical evidence of the health benefits of PFO closure in patients with cryptogenic stroke and migraines [