Epilepsy surgery in infants up to 3 months of age: Safety, feasibility, and outcomes: A multicenter, multinational study

Autor: Marcelo Volpon Santos, Shlomi Constantini, William Bingaman, James T. Rutka, Ajay Gupta, Francesco T. Mangano, Robert F. Keating, Sandi Lam, Mony Benifla, Chima O. Oluigbo, Giuseppe Cinalli, Manjari Tripathi, Aswin Chari, George I. Jallo, Swetha J. Sundar, Jonathan Roth, Georg Dorfmüller, James M. Drake, Michele Rizzi, Robert J. Bollo, Eveline Teresa Hidalgo, Jeffrey P. Blount, Christine Bulteau, Alessandro Consales, Martin Tisdall, Margaret Ekstein, Jeffrey M. Treiber, Hélio Rubens Machado, Nir Shimony, Cassia A.B. Maniquis, Shimrit Uliel-Sibony, Howard L. Weiner, Aria Fallah, Vladimir Shapira, Jeffrey H. Wisoff, Massimo Cossu, Gozde Erdemir, Poodipedi Sarat Chandra
Rok vydání: 2021
Předmět:
Zdroj: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
ISSN: 1528-1167
Popis: OBJECTIVE Drug-resistant epilepsy (DRE) during the first few months of life is challenging and necessitates aggressive treatment, including surgery. Because the most common causes of DRE in infancy are related to extensive developmental anomalies, surgery often entails extensive tissue resections or disconnection. The literature on "ultra-early" epilepsy surgery is sparse, with limited data concerning efficacy controlling the seizures, and safety. The current study's goal is to review the safety and efficacy of ultra-early epilepsy surgery performed before the age of 3 months. METHODS To achieve a large sample size and external validity, a multinational, multicenter retrospective study was performed, focusing on epilepsy surgery for infants younger than 3 months of age. Collected data included epilepsy characteristics, surgical details, epilepsy outcome, and complications. RESULTS Sixty-four patients underwent 69 surgeries before the age of 3 months. The most common pathologies were cortical dysplasia (28), hemimegalencephaly (17), and tubers (5). The most common procedures were hemispheric surgeries (48 procedures). Two cases were intentionally staged, and one was unexpectedly aborted. Nearly all patients received blood products. There were no perioperative deaths and no major unexpected permanent morbidities. Twenty-five percent of patients undergoing hemispheric surgeries developed hydrocephalus. Excellent epilepsy outcome (International League Against Epilepsy [ILAE] grade I) was achieved in 66% of cases over a median follow-up of 41 months (19-104 interquartile range [IQR]). The number of antiseizure medications was significantly reduced (median 2 drugs, 1-3 IQR, p
Databáze: OpenAIRE
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