Historical Risk Factors Associated with Seizure Outcome After Surgery for Drug-Resistant Mesial Temporal Lobe Epilepsy

Patient Historical Risk Factors Associated with Seizure Outcome After Surgery for Drug-Resistant Nonlesional Temporal Lobe Epilepsy

“…The historical risk factor associated with seizure outcome after surgery for drug-resistant nonlesional temporal lobe epilepsy in the current study (which was a history of febrile seizures in childhood) was different from such factor in mesial temporal lobe epilepsy patients (which was a history of tonic-clonic seizures in the year preceding surgery) in our previous study 14 . It is critical to distinguish among different types of TLE when assessing predictive factors for seizure outcome after surgery.…”

“…Our findings contrast with a previous study of 64 patients with nonlesional TLE in whom a history of preoperative tonicclonic seizure correlated with poor outcome 6 . When MRI or pathology clearly shows MTS, then preoperative tonic-clonic seizures reduce the chances of postoperative seizure freedom 10,14 .…”

Seizure clusters in drug‐resistant focal epilepsy

“…These reasons are likely to be different in people with temporal and extratemporal epilepsies, which could be a confounder of this study, but there were unlikely to be systematic differences in extent of resection or other features that would otherwise explain the difference. Furthermore, we did not take into account other factors that may impact postoperative outcome . Finally, our findings may not apply to the overall group of patients with uncontrolled seizures, as we had a special subgroup of patients with drug‐resistant focal epilepsy requiring surgery.…”

Remote preoperative tonic-clonic seizures do not influence outcome after surgery for temporal lobe epilepsy

“…Tonic-clonic seizures have been observed as a risk factor for seizure recurrence after ATL for drug-resistant MTS-TLE 6 . In one previous study of 116 consecutive patients who had temporal lobe surgery for drug-resistant epilepsy and MTS 9 , the occurrence of generalized tonic-clonic seizures was significantly associated with a poor outcome.…”

“…The potential efficacy of resective surgery in patients with drug resistant MTS-TLE is undisputed. However, there are still uncertainties about which patients will benefit most [3][4][5][6] . One of the most consistent risk factors associated with poor outcome after surgery for drug-resistant TLE in the literature is a history of preoperative tonic-clonic seizures [6][7][8][9] .…”