Predictors of epilepsy surgery outcome: a meta-analysis

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

“…This feature has never been examined in this population, as most previous reports have included patients with MRI-proven mesial temporal 8 sclerosis; such patients were excluded from our analysis. A previous meta-analysis of the predictors of temporal lobectomy outcome in a heterogeneous population of TLE patients found febrile seizures to be a strong prognostic indicator of seizure remission (odds ratio 0.48; 95% confidence interval 0.27-0.83) 7 , which is similar to our findings. In some previous studies, which included patients with MTS, a history of febrile seizure in childhood did not predict the seizure outcome after surgery 10,11 .…”

“…In our study, 56.8% of the patients had sustained seizure freedom and 70.5% of the patients were seizure free for one year or more in their last follow-up visit, which is concordant with most previous studies [6][7][8][9] . This study aimed to resolve ambiguities regarding the prognostic value of historical risk factors in drug-resistant nonlesional TLE after surgery and found only one to be relevant to the seizure outcome.…”

“…In drug-resistant TLE, resective brain surgery is superior to prolonged medical therapy 4 . However, there are still ambiguities about which patients will benefit most 7 . This is particularly true in the subgroup of patients with nonlesional TLE.…”

Expanding the role of surgery in intractable extratemporal pediatric epilepsy

“…15 Conversely, Holmes et al describe a worse outcome in this patient population given the prevalence of bilateral cortical injury. 12,26 The favorable results of a multilobar resection in Case 1, which involved a patient with a history of encephalitis and multifocal lesions (manifested by neuroimaging and clinically by cognitive delay with behavioral problems), implies 3 possibilities. First, the primary epileptogenic zone may have included a large region of the frontal and temporal lobes from the onset, or perhaps 2 epileptogenic sites coalesced into a synchronous seizure generator over time.…”

Failed epilepsy surgery for mesial temporal lobe sclerosis: a review of the pathophysiology

“…In reality, the vast majority of studies have failed to identify factors that are predictive of outcome. 1,14,16,25,33,38,51 Unfortunately, predictive clinical risk factors have remained elusive. Nevertheless, these patients should not be considered absolute failures of surgical management, instead they should be restudied to determine why surgery failed and to decide if further surgical intervention is indicated.…”