Outcomes of resective surgery in pediatric patients with drug-resistant epilepsy: A single-center study from the Eastern Mediterranean Region.

Autor: Mir A; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Jallul T; Department of Neurosurgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Alotaibi F; Neuroscience Centre, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia., Amer F; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.; Department of Pediatric Neurology and Metabolic, Cairo University Children Hospital, Cairo, Egypt., Najjar A; Department of Neurosurgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.; Department of Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia., Alhazmi R; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Al Faraidy M; Anesthesia Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Alharbi A; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Aldurayhim F; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Barnawi Z; Department of Neurosurgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Fallatah B; Department of Neurosurgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Ali M; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Almuhaish H; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Almolani F; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Suwailem A; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Tuli M; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Naim A; Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Hassan S; Department of Mental Health, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Hedgcock B; Department of Neurophysiology, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Bostanji G; Department of Social Work, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Bashir S; Neuroscience Centre, King Fahad Specialist Hospital, Dammam, Saudi Arabia., AlBaradie R; Department of Pediatric Neurology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Jazyk: angličtina
Zdroj: Epilepsia open [Epilepsia Open] 2023 Sep; Vol. 8 (3), pp. 930-945. Date of Electronic Publication: 2023 Jun 07.
DOI: 10.1002/epi4.12761
Abstrakt: Objective: Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug-resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed a retrospective study examining the outcomes of resective surgery in 53 pediatric patients with focal DRE.
Methods: Patients with focal DRE who had undergone epilepsy surgery were included in the present study. All patients underwent a comprehensive presurgical evaluation. Postoperative seizure outcomes were classified using the Engel Epilepsy Surgery Outcome Scale.
Results: After surgery, 33 patients (62.2%) were Class I according to the Engel classification of surgical outcomes; eight patients (15.0%) were Class II, 11 (20.7%) were Class III, and one (1.8%) was Class IV. The relationships of presurgical, surgical, and postsurgical clinical variables to seizure outcomes were compared. Older age at seizure onset, older age at the time of surgery, the presence of focal to bilateral tonic-clonic seizures, seizure duration over 2 minutes, unsuccessful treatment with three or fewer antiseizure medications, lesions confined to one lobe (as demonstrated via magnetic resonance imaging [MRI]), surgical site in the temporal lobe, and histopathology including developmental tumors were significantly linked to an Engel Class I outcome. A univariate analysis of excellent surgical outcomes showed that lateralized semiology, localized interictal and ictal electroencephalogram (EEG) discharges, lateralized single-photon emission computed tomography and positron emission tomography findings, and temporal lobe resections were significantly related to excellent seizure outcomes.
Significance: The results of our study are encouraging and similar to those found in other centers around the world. Epilepsy surgery remains an underutilized treatment for children with DRE and should be offered early.
(© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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