Outcome following surgery in patients with bitemporal interictal epileptiform patterns
| Autor: | Carl B. Dodrill, George A. Ojemann, Alan J. Wilensky, Michelle D. Holmes, Linda M. Ojemann |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Concordance Electroencephalography Functional Laterality Medical Records Seizures Febrile Temporal lobe Central nervous system disease Epilepsy medicine Humans Epilepsy surgery Ictal medicine.diagnostic_test Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Temporal Lobe Surgery Treatment Outcome Anesthesia Female Neurology (clinical) Psychology |
| Zdroj: | Neurology. 48:1037-1040 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.48.4.1037 |
| Popis: | We reviewed outcome at least 1 year after temporal lobectomy in 44 patients with bitemporal, independent, interictal epileptiform patterns on EEG. All 44 underwent preoperative intracranial monitoring. Twenty-two (50%) were seizure-free, 14 (32%) had at a least 75% reduction in seizures, and eight (18%) had less than a 75% reduction in seizures. We analyzed age of seizure onset, duration of epilepsy, gender, side of operation, history and clinical findings, findings on MRI, results of intracranial EEG-video monitoring, presence or absence of lateralizing neuropsychological deficits, and pathology of resected tissue to identify factors associated with outcome. Three factors emerged as independently associated with a good outcome: concordance of MRI abnormality and side of operation (p = 0.01), history of febrile seizures (p = 0.04), and 100% lateralization of intracranially recorded ictal onsets to the side of operation (p = 0.05). A seizure-free outcome was much more likely to occur if more than one of these factors was present: with at least two factors co-existing, 83% (15/18) of patients were seizure-free, while only 35% (7/20) were seizure-free with a single factor present (p = 0.0009). Of the six patients without any of the three factors, none were seizure-free. We conclude that it is possible to predict reasonably which patients with bitemporal epileptiform abnormalities will have a good outcome after surgery. |
| Databáze: | OpenAIRE |
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