Acute postoperative seizures as predictors of seizure outcomes after epilepsy surgery

Giridharan, Nisha; Horn, Paul S.; Greiner, Hansel M.; Holland, Katherine D.; Mangano, Francesco T.; Arya, Ravindra

doi:10.1016/j.eplepsyres.2016.08.026

Cited by 14 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, in a meta-analysis carried out in Cincinnati, USA, with 2028 patients, the male sex predominates (54.3 %), and the mean age is 10.24 ± 1.11 years. [14] Similar results were found in the Cuban series of Morales et al [6] with 55% male predominance and a mean age of 24.1 ± 10.1 (ranging 5 -47 years). The 2019 Cochrane review, [5] reports 30 to 50% seizure freedom after extratemporal epilepsy surgery.…”

Section: Discussionsupporting

confidence: 88%

Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

Santos¹

2021

JNNS

View full text Add to dashboard Cite

Introduction: Drug-resistant extratemporal epilepsy is the second cause of referral to epilepsy surgery. Objectives: To identify factors associated with short-term seizure recurrence following extratemporal epilepsy surgery. Materials and Methods: We performed a retrospective study of 19 consecutive patients who underwent surgery for drug-resistant extratemporal epilepsy at the National Institute of Neurology and Neurosurgery of Havana, Cuba, from September 2014 to October 2019. All patients had at least one year of postoperative follow-up. Fisher's exact test was used to search for an association between dichotomous variables. A value of p≤0.05 was considered significant. Results: After one year of follow-up, seizure freedom reached 31.6% (Engel I) and 36.8% showed significant improvement in the number of seizures (Engel II). The frontal location (p=0.046) and incomplete resection of the epileptogenic zone (p=0.017), bilateral interictal discharges on the preoperative electroencephalogram (EEG) (p=0.017), the presence of epileptiform discharges on the postsurgical EEG (p=0.001), and the occurrence of seizures after the sixth month of surgery (p=0.001), were associated with seizures recurrence. Conclusions: After one year, 31.6% of patients operated on for extratemporal epilepsy were seizure-free. The incomplete resection of the epileptogenic zone and the presence of epileptogenic discharges in the postsurgical EEG, and the presence of seizures after the sixth month of surgery were the most significant factors of seizure recurrence.

show abstract

Section: Discussionsupporting

confidence: 88%

Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

Santos¹

2021

JNNS

View full text Add to dashboard Cite

show abstract

“…Details on language and cognitive function can be found in the neuropsychological outcomes in Figure 2. 1,21,22 EEG at 6 months postsurgery was also a powerful tool to predict the likelihood of seizure freedom. 16 T A B L E 3 Pre-and postoperative functional status in 47 adult hemispherectomy patients contralateral hemisphere at the 6-month follow-up were predictive of seizure outcome.…”

Section: Predictors Of Seizure Outcomementioning

confidence: 99%

“…However, as shown in this and other studies, it is frequently a sign of early failure of surgery, particularly in patients with high preoperative seizure burden. 1,21,22 EEG at 6 months postsurgery was also a powerful tool to predict the likelihood of seizure freedom. None of the patients with Engel class I outcome had spikes in the contralateral hemisphere postoperatively.…”

Section: Predictors Of Seizure Outcomementioning

confidence: 99%

Hemispherectomy in adults and adolescents: Seizure and functional outcomes in 47 patients

et al. 2019

View full text Add to dashboard Cite

Objective: To examine longitudinal seizure and functional outcomes after hemispherectomy in adults and adolescents. Methods: We reviewed 47 consecutive patients older than 16 years who underwent hemispherectomy between 1996 and 2016 at our center. Clinical, electroencephalographic (EEG), imaging, neuropsychological, surgical, and functional status data were analyzed. Results: Thirty-six patients were 18 years or older at surgery; 11 were aged between 16 and 18 years. Brain injury leading to hemispheric epilepsy occurred before 10 years of age in 41 (87%) patients. At a mean follow-up of 5.3 postoperative years (median = 2.9 years), 36 (77%) had Engel class I outcome. Longitudinal outcome analysis showed 84% seizure freedom (Engel IA) at 6 months, 76% at 2 years, and 76% at 5 years and beyond, with stable longitudinal outcomes up to 12 years from surgery.Multivariate analysis demonstrated that acute postoperative seizures and contralateral interictal spikes at 6-month follow-up EEG were associated with seizure recurrence.Patients who could walk unaided preoperatively and had no cerebral peduncle atrophy on brain magnetic resonance imaging were more likely to experience worsening of motor function postoperatively. Otherwise, postoperative ambulatory status and hand function were unchanged. Of the 19 patients who completed neuropsychological testing, 17 demonstrated stable or improved postoperative outcomes. Significance: Hemispherectomy in adults is a safe and effective procedure, with seizure freedom rates and functional outcome similar to those observed in children. K E Y W O R D Sepilepsy surgery, hemispherectomy in adults, outcomes, refractory epilepsy

show abstract

“…MRgLITT for hippocampal ablation in temporal lobe epilepsy seems similar to open temporal lobectomy or amygdalohippocampectomy regarding the correlation of APOS with a lower chance of postoperative seizure freedom. A meta-analysis of 17 studies by Giridharan et al 17 found APOS to predict 1-year seizure outcomes after epilepsy surgery: 73.49% of patients who did not have APOS achieved seizure freedom at 1 year while only 38.96% of patients who had APOS achieved seizure freedom at 1 year. Of the 21 studies included in this analysis, 8 addressed extratemporal medically refractory epilepsy requiring procedures ranging from lobectomy to hemispherectomy.…”

Section: Discussionmentioning

confidence: 99%

Acute Postoperative Seizures and Engel Class Outcome at 1 Year Postselective Laser Amygdalohippocampal Ablation for Mesial Temporal Lobe Epilepsy

et al. 2022

View full text Add to dashboard Cite

BACKGROUND: MRI-guided laser interstitial thermal therapy (MRgLITT) for mesial temporal lobe epilepsy is a safe, minimally invasive alternative to traditional surgical approaches. Prognostic factors associated with efficacy are debated; preoperative epilepsy duration and semiology seem to be important variables. OBJECTIVE: To determine whether acute postoperative seizure (APOS) after MRgLITT for mesial temporal lobe epilepsy is associated with seizure freedom/Engel class outcome at 1 year. METHODS: A single-institution retrospective study including adults undergoing first time MRgLITT for mesial temporal lobe epilepsy (2010-2019) with ≥1-year follow-up. Preoperative data included sex, epilepsy duration, number of antiepileptics attempted, weekly seizure frequency, seizure semiology, and radiographically verified anatomic lesion at seizure focus. Postoperative data included clinical detection of APOS within 7 days postoperatively, and immediate amygdala, hippocampal, entorhinal, and parahippocampal residual volumes determined using quantitative imaging postprocessing. Primary outcome was seizure freedom/Engel classification 1 year postoperatively. RESULTS: Of 116 patients, 53% (n = 61) were female, with an average epilepsy duration of 21 (±14) years, average 6 failed antiepileptics (±3), and weekly seizure frequency of 5. APOS was associated with worse Engel class (P = .010), conferring 6.3 times greater odds of having no improvement vs achieving seizure freedom at 1 year. Residual amygdala, hippocampal, entorhinal, and parahippocampal volumes were not statistically significant prognostic factors. CONCLUSION: APOS was associated with a lower chance of seizure freedom at 1 year post-MRgLITT for mesial temporal lobe epilepsy. Amygdala, hippocampal, entorhinal, and parahippocampal residual volumes after ablation were not significant prognostic factors.

show abstract

Acute postoperative seizures as predictors of seizure outcomes after epilepsy surgery

Cited by 14 publications

References 29 publications

Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

Hemispherectomy in adults and adolescents: Seizure and functional outcomes in 47 patients

Acute Postoperative Seizures and Engel Class Outcome at 1 Year Postselective Laser Amygdalohippocampal Ablation for Mesial Temporal Lobe Epilepsy

Contact Info

Product

Resources

About