Long-term seizure outcome in frontal lobe epilepsy surgery

2019 ◽  
Vol 90 ◽  
pp. 93-98 ◽  
Author(s):  
Roberta Morace ◽  
Sara Casciato ◽  
Pier Paolo Quarato ◽  
Addolorata Mascia ◽  
Alfredo D’Aniello ◽  
...  
2021 ◽  
Vol 117 ◽  
pp. 107848
Author(s):  
Sara Casciato ◽  
Roberta Morace ◽  
Pier Paolo Quarato ◽  
Addolorata Mascia ◽  
Alfredo D'Aniello ◽  
...  

2019 ◽  
Vol 121 ◽  
pp. e32-e38 ◽  
Author(s):  
Cuiping Xu ◽  
Tao Yu ◽  
Guojun Zhang ◽  
Yuping Wang ◽  
Yongjie Li

2019 ◽  
Vol 140 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Joseph Samuel P ◽  
Ramshekhar N. Menon ◽  
Anuvitha Chandran ◽  
Sanjeev V. Thomas ◽  
George Vilanilam ◽  
...  

2007 ◽  
Vol 7 (4) ◽  
pp. 98-99 ◽  
Author(s):  
John W. Miller

Surgical Outcome and Prognostic Factors of Frontal Lobe Epilepsy Surgery. Jeha LE, Najm I, Bingaman W, Dinner D, Widdess-Walsh P, Luders H. Brain 2007;130(Pt 2):574–584. Epub 2007 Jan 5. Frontal lobe epilepsy (FLE) surgery is the second most common surgery performed to treat pharmacoresistant epilepsy. Yet, little is known about long-term seizure outcome following frontal lobectomy. The aim of this study is to investigate the trends in longitudinal outcome and identify potential prognostic indicators in a cohort of FLE patients investigated using modern diagnostic techniques. We reviewed 70 patients who underwent a frontal lobectomy between 1995 and 2003 (mean follow-up 4.1 ± 3 years). Data were analysed using survival analysis and multivariate regression with Cox proportional hazard models. A favourable outcome was defined as complete seizure-freedom, allowing for auras and seizures restricted to the first post-operative week. The estimated probability of complete seizure-freedom was 55.7% [95% confidence interval (CI) = 50–62] at 1 post-operative year, 45.1% (95% CI = 39–51) at 3 years, and 30.1% (95% CI = 21–39) at 5 years. Eighty per cent of seizure recurrences occurred within the first 6 post-operative months. Late remissions and relapses occurred, but were rare. After multivariate analysis, the following variables retained their significance as independent predictors of seizure recurrence: MRI-negative malformation of cortical development as disease aetiology [risk ratio (RR) = 2.22, 95% CI = 1.40–3.47], any extrafrontal MRI abnormality (RR = 1.75, 95% CI = 1.12–2.69), generalized/non-localized ictal EEG patterns (RR = 1.83, 95% CI = 1.15–2.87), occurrence of acute post-operative seizures (RR = 2.17, 95% CI = 1.50–3.14) and incomplete surgical resection (RR = 2.56, 95% CI = 1.66–4.05) (log likelihood-ratio test P-value < 0.0001). More than half of patients in favourable prognostic categories were seizure-free at 3 years, and up to 40% were seizure-free at 5 years, compared to <15% in those with unfavourable outcome predictors. These data underscore the importance of appropriate selection of potential surgical candidates.


Neurosurgery ◽  
2010 ◽  
Vol 67 (5) ◽  
pp. 1222-1229 ◽  
Author(s):  
Chi Heon Kim ◽  
Chun Kee Chung ◽  
Sang Kun Lee

Abstract BACKGROUND: Although the outcome of epilepsy surgery changes with time, few studies have considered longitudinal changes after frontal lobe epilepsy (FLE) surgery. OBJECTIVE: To assess the longitudinal changes after FLE surgery. METHODS: Resection of the seizure onset zone was performed in 76 patients with FLE. Invasive monitoring was performed in 56 of these 76. Awake craniotomy was performed in 43 of the 76 patients. More than 50% of patients were followed up for at least 7 years. The mean follow-up was 81 months. RESULTS: For all patients, the seizure-free rate was 79% at 6 months, 64% at 1 year, 55% at 2 years, and 55% at 7 years. For patients with cortical dysplasia, the seizure-free rate was 72% at 6 months, 53% at 1 year, 51% at 2 years, and 46% at 7 years. For patients with tumor, the seizure-free rate was 89% at 6 months, 83% at 1 year, 83% at 2 years, and 74% at 7 years. Patients with tumor showed better outcome than those with cortical dysplasia (P = .04). Although the overall seizure-free rate became stable after 2 years, individual status changed for up to 5 years. Seizures recurred in 11 patients within 1 year (early recurrence) and in 12 patients by 1 to 5 years (late recurrence). Antiepileptic drug (AED) medication was adjusted in all patients with recurrence. Patients with late recurrence had a more favorable response (Engel class I or II) than early recurrence (P &lt; .01). CONCLUSION: The overall seizure outcome changes mostly during the first year. However, individual seizure status changes for up to 5 years. The outcome of late recurrence is favorable to AED adjustment.


1997 ◽  
Vol 69 (1-4) ◽  
pp. 202-209 ◽  
Author(s):  
J.R. Smith ◽  
M.R. Lee ◽  
D.W. King ◽  
A.M. Murro ◽  
Y.D. Park ◽  
...  

2017 ◽  
Vol 32 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Krista J. Qualmann ◽  
Christine G. Spaeth ◽  
Melanie F. Myers ◽  
Paul S. Horn ◽  
Katherine Holland ◽  
...  

Central nervous system comorbidities have been identified in patients with epilepsy. Several of these comorbidities have been correlated with poor surgery outcomes in patient cohorts. The authors sought to determine if prevalence of comorbidities in pediatric epilepsy surgery patients and their families correlate with long-term seizure outcome in a cross-sectional analysis. Three-generation pedigrees were elicited to compare family history of epilepsy, ADHD, anxiety, autism, bipolar disorder, cognitive disability, depression, migraine, and motor disability to surgery outcomes in 52 patients. Proportions of affected patients and relatives were compared to general population comorbidity rates and the patients’ most recent seizure outcome classification. Patients and families had significantly higher rates of comorbidities than the general population. Poorer long-term seizure outcomes following resective surgery were associated with autism or cognitive disability in patients. Together these data support evidence for a common pathophysiological mechanism between epilepsy and central nervous system comorbidities.


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