Clinical characteristics, surgical and neuropsychological outcomes in drug resistant tumoral temporal lobe epilepsy

Ravat, Sangeeta; Iyer, Vivek; Muzumdar, Dattatraya; Shah, Urvashi; Pradhan, P.K.; Jain, Neeraj; Godge, Yogesh

doi:10.1016/j.ijsu.2015.10.015

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…Table 4 shows neurostimulative techniques like VNS [57,86,120,138,151,157,173] and deep brain stimulation [73], which reflected that the majority of subjects had more than 50% seizure reduction with follow-ups ranging between one to four years. Table 5 showed that the indicators of QOL improved after surgery [37,47,50,59,93,98,101,122,126,134,159,160,165,175,177], except in one study [62]. Table 6 reports on the cost of epilepsy surgery [66,70,71,114,117,144,147,164,168,171,172] and VNS [138], the cost of epilepsy surgery as at 2014 ranges between US$500 in Iran to approximately US$8,000 in China.…”

Section: Tunisian Epilepsy Surgery Program At the Charles Nicolle Hosmentioning

confidence: 99%

Epilepsy surgery in low- and middle-income countries: A scoping review

Watila

Xiao

Keezer

et al. 2019

Epilepsy & Behavior

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Background: Epilepsy surgery is an important treatment option for people with drug resistant epilepsy. Although surgical procedures are under-utilized worldwide, it is far worse in Low-and Middle-Income Countries (LMIC) and it is less clear to what extent people with drug resistant epilepsy receive such treatment at all. Here we review the existing evidence for the availability and outcome of epilepsy surgery in LMIC, and discuss some challenges and priority. Methods: We used the six stage methodological framework developed by Arskey and O'Malley as a guide. We searched PubMed, Embase, Global Health Archives, Index Medicus for South East Asia Region (IMSEAR), Index Medicus for Eastern Mediterranean Region (IMEMR), Latin American & Caribbean Health Sciences Literature (LILACS), African Journal Online (AJOL), and African Index Medicus (AIM) to identify the relevant literature. Results: We retrieved 148 articles on epilepsy surgery from 31 countries representing 22% of the 143 LMIC. Epilepsy surgery appears established in some of these centers in Asia and Latin America, while some are in their embryonic stage reporting procedures in a small cohort performed mostly by motivated neurosurgeons. The commonest surgical procedure reported was temporal lobectomies. The post-operative seizure-free rates and quality of life are comparable to those in the high-income countries (HIC). Some models have shown that epilepsy surgery can be performed within a resourcelimited setting through collaboration with international partners and through the use of information and communication technology. The cost of surgery is a fraction of what is available in HIC. Conclusion: This review has demonstrated the availability of epilepsy surgery in few LMIC. The information available is inadequate to make any reasonable conclusion of its existence as routine practice. Collaborations with international partners can provide an opportunity to bring high-quality academic training and technological transfer directly to surgeons working in these regions and should be encouraged.

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Section: Tunisian Epilepsy Surgery Program At the Charles Nicolle Hosmentioning

confidence: 99%

Epilepsy surgery in low- and middle-income countries: A scoping review

Watila

Xiao

Keezer

et al. 2019

Epilepsy & Behavior

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“…The tumors arise most commonly in the temporal lobe; hence, they may cause drug-resistant limbic seizures. Complete resection of the tumor is generally sufficient for seizure relief [ 4 , 5 , 6 ]. Tumor invasion of the hippocampus or hippocampal sclerosis can be associated with temporal LEATs.…”

Section: Introductionmentioning

confidence: 99%

Is Hippocampal Resection Necessary for Low-Grade Epilepsy-Associated Tumors in the Temporal Lobe?

et al. 2022

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Low-grade epilepsy-associated tumors (LEATs) are common in the temporal lobe and can cause drug-resistant epilepsy. Complete resection of LEATs is sufficient for seizure relief. However, hippocampal resection might result in postoperative cognitive impairment. This study aimed to clarify the necessity of hippocampal resection for seizure and cognitive outcomes in patients with temporal lobe LEATs and a normal hippocampus. The study included 32 patients with temporal lobe LEATs and without hippocampal abnormalities. All patients underwent gross total resection as treatment for drug-resistant epilepsy at our tertiary epilepsy center from 2005 to 2020, followed by at least a 12-month follow-up period. Seizure and cognitive outcomes were compared between patients who underwent additional hippocampal resection (Resected group) and those who did not (Preserved group). Among the participants, 14 underwent additional hippocampal resection and 28 (87.5%) achieved seizure freedom irrespective of hippocampal resection. The seizure-free periods were not different between the two groups. Additional hippocampal resection resulted in a significantly negative impact on the postoperative verbal index. In conclusion, additional hippocampal resection in patients with temporal lobe LEATs without hippocampal abnormalities is unnecessary because lesionectomy alone results in good seizure control. Additional hippocampal resection may instead adversely affect the postoperative language function.

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