Seizure outcome after epilepsy surgery in children and adolescents
Autor: | Youssef G. Comair, Juan Bulacio, William Bingaman, Elaine Wyllie, Prakash Kotagal, Paul Ruggieri |
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Rok vydání: | 1998 |
Předmět: |
Adult
medicine.medical_specialty Pediatrics Time Factors Adolescent Video Recording Neurological disorder Hippocampus Central nervous system disease Epilepsy Postoperative Complications Fluorodeoxyglucose F18 Seizures medicine Humans Epilepsy surgery Child Retrospective Studies Hippocampal sclerosis Sclerosis business.industry Age Factors Infant Electroencephalography Retrospective cohort study Cortical dysplasia medicine.disease Magnetic Resonance Imaging Temporal Lobe Surgery Treatment Outcome Neurology El Niño Child Preschool Neurology (clinical) Radiopharmaceuticals business Follow-Up Studies Tomography Emission-Computed |
Zdroj: | Annals of Neurology. 44:740-748 |
ISSN: | 1531-8249 0364-5134 |
Popis: | Few epilepsy surgery outcome data are available from series of pediatric patients. We studied seizure outcome in 136 pediatric patients who had surgery for intractable epilepsy at The Cleveland Clinic between January 1990 and June 1996, with a postoperative follow-up of 1 to 7.5 years (mean, 3.6 years). Sixty-two children (3 months to 12 years old at time of surgery) were compared with 74 adolescents (13-20 years old). Extratemporal or multilobar resections and hemispherectomies were similarly frequent among children (50%) and adolescents (44%), but these procedures strongly predominated in infancy (90% of patients 0-2 years of age). The remaining patients had temporal resection. Cortical dysplasia and low-grade tumor were the most common causes and hippocampal sclerosis was rare. Seizure-free outcome was achieved for 69% of adolescents, 68% of children, and 60% of the infant subgroup, overall; for 23 (74%) of 31 children and 33 (80%) of 41 adolescents after temporal resection; for 11 (58%) of 19 children and 15 (52%) of 29 adolescents after extratemporal or multilobar resection; and for 8 (67%) of 12 children and 3 (75%) of 4 adolescents after functional hemispherectomy. Seizure-free outcome was more frequent after temporal resection (56 of 72, 78%) than after extratemporal or multilobar resection (26 of 48, 54%; 41 of 48 with a focal lesion on magnetic resonance imaging), and among patients with tumor (36 of 44, 82%) versus cortical dysplasia (16 of 31, 52%). The frequency of seizure-free outcome after epilepsy surgery was similar for infants, children, and adolescents, and comparable with results from adult series. Most patients in each age, surgery type, and causal group were free from seizures after surgery. These results suggest that children should be considered for surgical evaluation at whatever age they manifest with severe, intractable, disabling localization-related epilepsy. |
Databáze: | OpenAIRE |
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