Outcome of epilepsy surgery in children after evaluation with non-invasive protocol
| Autor: | Megha S Uppin, Shanmukhi Somayajula, Manas Panigrahi, Sundaram Challa, Sita Jayalakshmi, Dilip Kumar Kulkarni |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Neurosurgery Video Recording Logistic regression Hippocampus Epilepsy Predictive Value of Tests medicine Humans Epilepsy surgery Postoperative Period Child Retrospective Studies Tomography Emission-Computed Single-Photon Hippocampal sclerosis business.industry Retrospective cohort study Electroencephalography Stepwise regression medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome Neurology Predictive value of tests Child Preschool Female Neurology (clinical) Age of onset business Follow-Up Studies |
| Zdroj: | Neurology India. 59(1) |
| ISSN: | 0028-3886 |
| Popis: | Objective : To assess outcome of epilepsy surgery in children with medically refractory partial epilepsy evaluated with non-invasive protocol and to determine the predictors of outcome. Patients and Methods : Retrospective analysis of presurgical, surgical, and postsurgical data was performed in 87 children who had at least 1 year post surgery follow-up. Outcome was assessed according to Engel's outcome classification. Stepwise regression followed by logistic regression analysis was employed in data analysis. Results : Mean follow-up was 32 (12-58) months and 44 (50.6%) were males. The age of onset of epilepsy was below the age of 2 years in 24 (30.8%). Resective surgery was done in 78 children. The commonest surgery performed was a temporal resection (88.9%) in adolescents and an extra-temporal resection ( 60.6%) in children. The commonest pathology was hippocampal sclerosis (HS) in adolescents and developmental, tumoral lesions, and gliosis in children. At last follow-up, 50 (64.1%) were seizure free and Engel's favourable outcome was noted in 59 (75.6%). After stepwise regression analysis, variables found to be significant (P < 0.05) and predicting a favourable outcome were lesion on MRI, normal IQ, and partial seizures without secondary generalization. Bilateral spikes on interictal EEG and acute postoperative seizures were predictors of poor outcome. A regression model was developed; the sensitivity, specificity, accuracy, and area under ROC curve were 82%, 91%, 88.5%, and 0.97%, respectively. Conclusion : Favourable outcome after epilepsy surgery can be obtained in children with temporal lobe epilepsy with HS and lesion-related epilepsies in developing countries with limited resources, after evaluation with a non-invasive protocol. |
| Databáze: | OpenAIRE |
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