Long-term outcome of extratemporal epilepsy surgery among 154 adult patients.

Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Research Abstract Details 

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Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Abstract Text:

Alaa Eldin Elsharkawy,Friedrich Behne,Falk Oppel,Heinz Pannek,Reinhard Schulz,Mathias Hoppe,Gerald Pahs,Csilla Gyimesi,Mohamed Nayel,Ahmed Issa,Alois Ebner,

Object The goal of this study was to evaluate the long-term outcome of patients who underwent extratemporal epilepsy surgery and to assess preoperative prognostic factors associated with seizure outcome. Methods This retrospective study included 154 consecutive adult patients who underwent epilepsy surgery at Bethel Epilepsy Centre, Bielefeld, Germany between 1991 and 2001. Seizure outcome was categorized based on the modified Engel classification. Survival statistics were calculated using Kaplan-Meier curves, life tables, and Cox regression models to evaluate the risk factors associated with outcomes. Results Sixty-one patients (39.6%) underwent frontal resections, 68 (44.1%) had posterior cortex resections, 15 (9.7%) multilobar resections, 6 (3.9%) parietal resections, and 4 (2.6%) occipital resections. The probability of an Engel Class I outcome for the overall patient group was 55.8% (95% confidence interval [CI] 52-58% at 0.5 years), 54.5% (95% CI 50-58%) at 1 year, and 51.1% (95% CI 48-54%) at 14 years. If a patient was in Class I at 2 years postoperatively, the probability of remaining in Class I for 14 years postoperatively was 88% (95% CI 78-98%). Factors predictive of poor long-term outcome after surgery were previous surgery (p = 0.04), tonic-clonic seizures (p = 0.02), and the presence of an auditory aura (p = 0.03). Factors predictive of good long-term outcome were surgery within 5 years after onset (p = 0.015) and preoperative invasive monitoring (p = 0.002). Conclusions Extratemporal epilepsy surgery is effective according to findings on long-term follow-up. The outcome at the first 2-year follow-up visit is a reliable predictor of long-term Engel Class I postoperative outcome.

Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Publishing Authors By Initials

AE Elsharkawy,F Behne,F Oppel,H Pannek,R Schulz,M Hoppe,G Pahs,C Gyimesi,M Nayel,A Issa,A Ebner,

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Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of neurosurgery

VOLUME: 108

Page Numbers: 676-86

Journal Abbreviation: J. Neurosurg.

ISSN: 0022-3085

DAY: 1

MONTH: Apr

YEAR: 2008

Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Information

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LANGUAGE: eng

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AFFILIATION: 1 Department of Presurgical Evaluation and, 2 Neurosurgical Department, Bethel Epilepsy Centre, Bielefeld, Germany; and, 3 Neurosurgical Department, Cairo University, Cairo, Egypt.

Country: United States

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MEDLINETA: J Neurosurg

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