Do auras predict seizure outcome after temporal lobe epilepsy surgery?
| Autor: | R. Ashalatha, Ramshekhar N. Menon, Deepak Menon, Ajith Cherian, Sankara P. Sarma, Bejoy Thomas, Mathew Abraham, George C Vilanilam, Anuvitha Chandran, V.C. Soumya, Chandrashekharan Kesavadas, Sanjeev V Thomas |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Drug Resistant Epilepsy medicine.medical_specialty Aura medicine.medical_treatment Logistic regression Statistics Nonparametric Temporal lobe Cohort Studies Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Predictive Value of Tests medicine Humans Ictal Epilepsy surgery Anterior temporal lobectomy business.industry Seizure outcome Electroencephalography Anterior Temporal Lobectomy medicine.disease Magnetic Resonance Imaging Surgery Logistic Models Treatment Outcome 030104 developmental biology Epilepsy Temporal Lobe Neurology Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsy Research. 147:109-114 |
| ISSN: | 0920-1211 |
| DOI: | 10.1016/j.eplepsyres.2018.08.006 |
| Popis: | Purpose The success of epilepsy surgery lies in identifying the ictal onset zone accurately. The significance of auras has little been explored on surgical outcome in drug-resistant epilepsy. This study focuses on the clinicopathological correlation of aura(s) and its role in predicting surgical outcome in drug-resistant temporal lobe epilepsy (TLE). We compared surgical outcome in TLE between patients with and without aura and identified the clinico-pathological, radiological and surgical differences between the two groups. Methods Consecutive patients who underwent presurgical evaluation from January 2009 to December 2014 for drug-resistant TLE who underwent anterior temporal lobectomy (ATL) were included. Patients were followed up at 3months, 12 months and then annually. Results Among 456 patients, 344(75%) had aura. Multivariate logistic regression showed that prototype EEG pattern at ictal onset (OR 2.12, 95% CI 1.18–3.06, p = 0.012) and right sided epileptogenic zone (OR 1.82 95% CI 1.18–3.78, p = 0.007) were significantly associated with presence of aura. There was no difference in surgical outcome between those with and without aura. But patients with auditory aura (OR 7.28, CI 2.80–18.95, p = 0.0002) and vertiginous aura (OR 3.01, CI 1.55–7.85, p = 0.028) had a poor surgical outcome. Bivariate analysis showed that normal MRI (p = 0.028) and normal/indeterminate pathology (p = 0.001) were significantly more common with auditory/vertiginous auras. Conclusions Mere presence of aura does not affect outcome after TLE surgery. However, auditory and vertiginous auras are predictors of poor surgical outcome. These patients require more extensive screening for an ictal onset zone beyond standard limits of ATL before surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect