Complications of epilepsy surgery in Sweden 1996–2010: a prospective, population-based study

Abstract

OBJECT Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series. METHODS The Swedish National Epilepsy Surgery Register provides extensive population-based data on all patients who were surgically treated in Sweden since 1990. The authors have analyzed complication data for therapeutic epilepsy surgery procedures performed between 1996 and 2010. Complications are classified as major (affecting daily life and lasting longer than 3 months) or minor (resolving within 3 months). RESULTS A total of 865 therapeutic epilepsy surgery procedures were performed between 1996 and 2010, of which 158 were reoperations. There were no postoperative deaths. Major complications occurred in 26 procedures (3%), and minor complications in 65 (7.5%). In temporal lobe resections (n = 523), there were 15 major (2.9%) and 41 minor complications (7.8%); in extratemporal resections (n = 275) there were 9 major (3.3%) and 22 minor complications (8%); and in nonresective procedures (n = 67) there were 2 major (3%) and 2 minor complications (3%). The risk for any complication increased significantly with age (OR 1.26 per 10-year interval, 95% CI 1.09–1.45). Compared with previously published results from the same register, there is a trend toward lower complication rates, especially in patients older than 50 years. CONCLUSIONS This is the largest reported prospective series of complication data in epilepsy surgery. The complication rates comply well with published results from larger single centers, confirming that epilepsy surgery performed in the 6 Swedish centers is safe. Patient age should be taken into account when counseling patients before surgery.

Major and minor complications in extraoperative electrocorticography: A review of a national database

“…Complications were classified as major or minor, following prior studies of epilepsy surgery (Bjellvi et al, 2015; Hader et al, 2013). In short, major complications were defined as those likely to produce effects persisting >3 months, while minor complications were those expected to resolve in <3 months.…”

Reappraisal of corpus callosotomy

“…Only one permanent complication was reported [17]. In a recent study from the prospective and populationbased Swedish National Epilepsy Surgery Register, one major complication was reported in 31 corpus callosotomy procedures [7]. Minor complications, for example, transient mild hemiparesis, are not specified and acute disconnection syndrome is only described in 43 out of the 289 reported patients.…”

“…The use of intraoperative frameless stereotactic neuronavigation has been shown to be a well tolerated, effective, and important adjunct for the planning of corpus callosotomy [6], and it is now possible to perform corpus callosotomy safely with modern microneurosurgical techniques with a low surgical risk [7].…”

Complications of Epilepsy Surgery: A Single Surgeon's Experience from South India

“…However, Bjellvi et al, 26 in a multicenter epilepsy surgery trial from Sweden, recently reported increased odds for complications at 1.26 times per 10-year interval. Average age of our cohort was nearly 21 years, which may account for our failure to observe a significant difference for complications between children and adults.…”