BACKGROUND:Anterior temporal lobectomy is the most effective treatment for intractable temporal lobe epilepsy (TLE). However, patients are reluctant to choose this surgery for fear of risks after large frontotemporal craniotomy, and epileptologists likewise have a cautious attitude because of surgical trauma. Functional anterior temporal lobectomy (FATL) is a minimally invasive surgery procedure for addressing the above concerns.OBJECTIVE:To report preliminary data on this procedure and its safety and efficacy for treating TLE.METHODS:This consecutive case series study was conducted between October 2020 and September 2021. Patients with TLE underwent FATL by minicraniotomy with a diameter of 3 cm. Surgery duration, postoperative complications, and seizure control are described herein. Seizure outcomes were classified using Engel classifications.RESULTS:A total of 25 patients undergoing FATL for TLE were enrolled. The median epilepsy duration was 8 years. The median surgery duration was 165 min. The median blood loss was 100 mL. The median postoperative hospital stay was 8 days. No deaths occurred after surgery. Only 1 patient presented with a cerebrospinal fluid disorder that was successfully treated using a ventriculoperitoneal shunt. At the last follow-up, 23 patients (92%) were seizure-free (Engel-Ia), 1 patient remained substantially improved (Engel-II), and 1 patient obtained worthwhile seizure reduction (Engel-III).CONCLUSION:Our pilot study suggests that FATL is a viable surgical therapy for TLE. This method has the advantages of minimal invasiveness and high seizure-free rate. A controlled trial is warranted to verify the efficacy and safety of FATL comparing with anterior temporal lobectomy.
The predictors of long-term seizure outcomes after resectivesurgery for focal epilepsy, for an update on the features of good and poor outcomes is investigated. A retrospective study of patients with focal epilepsy undergoing resectivesurgery from March 2011 toApril 2019 was performed. There were 3 groups according to the seizure outcomes: group A, seizure freedom; group B, seizure improvement; group C, no improvement. Five comparisons were performed: comparison 1, A vs. B and C; comparison 2, A vs. B; comparison 3, A vs. C; comparison 4, B vs. C; comparison 5, A and B vs. C. Predictors of seizure outcomes were identi ed by multivariate logistic regression analysis. Of all 833 patients, 561 (67.3%) patients remained seizure-free at the last follow-up, 203 (24.4%) patients had seizure improvement, and 69 (8.3%) had no improvement. The mean follow-up duration was 5.2 years (range: 2.7 to 9.6). Predictors of better outcomes included epilepsyduration <5 years (comparisons 1-3), localized discharge (comparisons 1 and 2), no. of antiepileptic drugs at surgery <3 (comparison 5), and temporal lobe resection (comparisons 1 and 3). However, predictors of worse outcomes included intracranial haemorrhage in infancy (comparisons 1 and 2), interictal abnormal discharge (comparisons 1 and 2), intracranial electrode monitoring (comparisons 1 and 2), and acute postoperative seizure (all comparisons). Our study suggests that resectivesurgery for focal epilepsy has satisfactory outcomes. Short epilepsy duration, localized discharge, and temporal lobe resection are positive predictors of seizure freedom. Patients with these predictors are intensivelyrecommended for surgery.
The predictors of long-term seizure outcomes after resectivesurgery for focal epilepsy, for an update on the features of good and poor outcomes is investigated. A retrospective study of patients with focal epilepsy undergoing resectivesurgery from March 2011 toApril 2019 was performed. There were 3 groups according to the seizure outcomes: group A, seizure freedom; group B, seizure improvement; group C, no improvement. Five comparisons were performed: comparison 1, A vs. B and C; comparison 2, A vs. B; comparison 3, A vs. C; comparison 4, B vs. C; comparison 5, A and B vs. C. Predictors of seizure outcomes were identified by multivariate logistic regression analysis. Of all 833 patients, 561 (67.3%) patients remained seizure-free at the last follow-up, 203 (24.4%) patients had seizure improvement, and 69 (8.3%) had no improvement. The mean follow-up duration was 5.2 years (range: 2.7 to 9.6). Predictors of better outcomes included epilepsyduration <5 years (comparisons 1-3), localized discharge (comparisons 1 and 2), no. of antiepileptic drugs at surgery <3 (comparison 5), and temporal lobe resection (comparisons 1 and 3). However, predictors of worse outcomes included intracranial haemorrhage in infancy (comparisons 1 and 2), interictal abnormal discharge (comparisons 1 and 2), intracranial electrode monitoring (comparisons 1 and 2), and acute postoperative seizure (all comparisons). Our study suggests that resectivesurgery for focal epilepsy has satisfactory outcomes. Short epilepsy duration, localized discharge, and temporal lobe resection are positive predictors of seizure freedom. Patients with these predictors are intensivelyrecommended for surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.