Epilepsy surgery for refractory seizures: a systematic review and meta-analysis in different complications

Abstract

Background: Nearly one-third of epilepsy patients are refractory/resistant to medical treatment. Developments made in surgical techniques have significantly increased the effectiveness and safety of these techniques, as such techniques have been demonstrated to improve seizure control/freedom outcomes. Objectives: The aim of this systematic review and meta-analysis was to evaluate the complications of epilepsy surgery. Patient and methods: The searches were conducted by three independent researchers to find the relevant studies published from January 1, 2009, until the end of January 6, 2019. For English published statistical studies, all studies conducted on epileptic patients who have undergone epilepsy surgery were included. Statistical analysis: A meta-analysis was conducted in the STATA14 statistical software. Results: A total of 6735 patients with epilepsy who had undergone the epilepsy surgery were studied. The overall prevalence of complications was 5%. The prevalence of major and minor complications was 5.4% and 3.2% respectively. The prevalence of complications related to the temporal epilepsy surgery and the extra-temporal epilepsy surgery based on 3 studies was 7.9% and 8.2 % respectively. The frequency of neurological and surgical complications after epilepsy surgery was 4.4% and 4.1% respectively. Conclusion: The overall rate of complications caused by epilepsy surgery was reasonably low (5%), implying that epilepsy surgery especially temporal lobe resection can be safe preferably when performed by an experienced surgeon.

Pengaruh Diet Ketogenik terhadap Ketebalan dan Elastisitas Arteri Karotis pada Pasien Epilepsi: A Systematic Review

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Biodegradable nanoparticles for the treatment of epilepsy: From current advances to future challenges

“…Finally, other option that have been reported to be helpful is the ketogenic diet, which has been described to be able to reduce the number of epileptic seizures, especially in children population. [14][15][16] 3 | OVERCOMING THE BLOOD -…”

“…If the pharmacological treatment is not effective, there are other therapeutic alternatives such as electrostimulation of the vagus nerve or deep brain stimulation by means of devices that are implanted in the patient's body. Finally, other option that have been reported to be helpful is the ketogenic diet, which has been described to be able to reduce the number of epileptic seizures, especially in children population 14‐16 …”

Clinician preferences for neurotechnologies in pediatric drug‐resistant epilepsy: A discrete choice experiment

“…However, conventional surgery is an irreversibly invasive, open procedure that requires a large scalp incision, temporary removal of sections of the skull, excision of the epileptogenic focus within the brain, and—in extreme cases—the removal or disconnection of the affected hemisphere of the brain. This invasiveness comes with significant risks including infection, bleeding, injury to the areas of the brain proximal to the resection, impairment of memory, stroke, and sometimes death 12 . Recovery from conventional surgery may be a lengthy process involving an extended stay in hospital and rehabilitation after discharge.…”

“…This invasiveness comes with significant risks including infection, bleeding, injury to the areas of the brain proximal to the resection, impairment of memory, stroke, and sometimes death. 12 Recovery from (RF1 # MH117805 01; JI, Principal Investigator; PJM, co-Principal Investigator).…”