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Predictors of seizure outcome after temporal lobectomy for intractable epilepsy
Author(s) -
Stavem K.,
Bjørnæs H.,
Langmoen I. A.
Publication year - 2004
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1046/j.1600-0404.2003.00249.x
Subject(s) - ictal , anterior temporal lobectomy , epilepsy , temporal lobe , epilepsy surgery , cortical dysplasia , hippocampal sclerosis , magnetic resonance imaging , medicine , electroencephalography , surgery , psychology , radiology , psychiatry
Objectives – To assess predictors of outcome of temporal lobectomy for intractable epilepsy. Material and methods – In 63 adult patients operated with anterior temporal lobectomy during 1988–92, we used logistic regression analysis to assess predictors of being seizure‐free (Engel's class I) 2 years after surgery. As potential predictors, we included the following variables: gender, age at operation, age at onset of seizures, epilepsy duration, etiology, generalized vs not generalized seizures, seizure frequency, intelligence quotient, ictal electroencephalography, magnetic resonance imaging (MRI), single‐photon emission computed tomography (SPECT), side of resection, and extent of the resection. Results – About 44% of the surgery patients were seizure‐free (Engel's class I) 2 years after surgery. In multivariate analysis ( n = 55), MRI pathology defined as atrophy in the temporal lobe, angioma, tumor or mesial temporal sclerosis (odds ratio, OR 7.4, 95%CI: 1.7–32.9) and extent of the hippocampal resection (increase of 1 cm) (OR 2.2, 95%CI: 1.1–4.6) predicted being seizure‐free. Conclusion – Focal pathology in preoperative MRI and the extent of the hippocampal resection were the only significant predictors of being seizure‐free after 2 years.