Seizure outcome after epilepsy surgery for patients with normal MRI: A Single center experience

Alsumaili, Mohammad; AlKhateeb, Mashael; Khoja, Abeer; Alkhaja, Mohammed; Alsulami, Ashwaq; Alqadi, Khalid; Baz, Salah; Abalkhail, Tariq; Babtain, Fawzi; Althubaiti, Ibrahim; Abu-Ata, Mahmoud; Alotaibi, Faisal

doi:10.1016/j.eplepsyres.2021.106620

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…Several other groups have reported success rates around the 40% range for resections of nonlesional epilepsies. 9,33,34 We believe that this discrepancy can be, in part, explained by differing risk tolerances among various epilepsy surgery centers, that is, offering surgery only to the most hopeful cases will lead to better outcomes, although some patients who would have benefitted from the procedure can be left out. Also, the previously published studies have analyzed outcomes 1-or 2-year postresection, some patients, however, can experience seizure recurrence even after several years of a seizure-free period.…”

Section: Discussionmentioning

confidence: 99%

Twenty‐five years of epilepsy surgery at a Central European comprehensive epilepsy center—Trends in intervention delay and outcomes

et al. 2023

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ObjectiveWe analyzed trends in patients' characteristics, outcomes, and waiting times over the last 25 years at our epilepsy surgery center situated in Central Europe to highlight possible areas of improvement in our care for patients with drug‐resistant epilepsy.MethodsA total of 704 patients who underwent surgery at the Brno Epilepsy Center were included in the study, 71 of those were children. Patients were separated into three time periods, 1996‐2000 (n = 95), 2001‐2010 (n = 295) and 2011‐2022 (n = 314) based on first evaluation at the center.ResultsThe average duration of epilepsy before surgery in adults remained high over the last 25 years (20.1 years from 1996 to 2000, 21.3 from 2001 to 2010, and 21.3 from 2011 to 2020, P = 0.718). There has been a decrease in rate of surgeries for temporal lobe epilepsy in the most recent time period (67%—70%—52%, P < 0.001). Correspondingly, extratemporal resections have become more frequent with a significant increase in surgeries for focal cortical dysplasia (2%—8%—19%, P < 0.001). For resections, better outcomes (ILAE scores 1a‐2) have been achieved in extratemporal lesional (0%—21%—61%, P = 0.01, at least 2‐year follow‐up) patients. In temporal lesional patients, outcomes remained unchanged (at least 77% success rate). A longer duration of epilepsy predicted a less favorable outcome for resective procedures (P = 0.024) in patients with disease duration of less than 25 years.SignificanceThe spectrum of epilepsy surgery is shifting toward nonlesional and extratemporal cases. While success rates of extratemporal resections at our center are getting better, the average duration of epilepsy before surgical intervention is still very long and is not improving. This underscores the need for stronger collaboration between epileptologists and outpatient neurologists to ensure prompt and effective treatment for patients with drug‐resistant epilepsy.

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Section: Discussionmentioning

confidence: 99%

Twenty‐five years of epilepsy surgery at a Central European comprehensive epilepsy center—Trends in intervention delay and outcomes

et al. 2023

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“…(3) Studies of frontal lobe epilepsy surgery are usually in smaller cohorts and typically report seizure outcomes at individual time-points using single outcome measures, which may not capture postoperative seizure remission and relapse patterns. (4)(5)(6)(7)(8) Seizure freedom is considered the most critical factor affecting the quality of life and employment following epilepsy surgery, but analysis of long-term socioeconomic outcomes has been constrained by a lack of standardized composite quality of life scores. (7,9,10) Several factors, including physical and psychiatric comorbidities following surgery, are likely to influence socioeconomic outcomes and quality of life, as well as seizure freedom.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies identified several factors associated with favorable outcomes after surgery, such as a focal abnormality on MRI, shorter duration of epilepsy and younger age at the time of surgery. (4)(5)(6)(7)(8) Some results are conflicting, with equally good outcomes between those with normal and abnormal MRI scans reported (1,7,12), and variable associations between duration of epilepsy and postoperative seizure freedom. (5) Further, the significance of factors such as needing intracranial EEG (icEEG) and extent of resection are less well defined in frontal lobe, as opposed to temporal lobe, epilepsy surgery.…”

Section: Introductionmentioning

confidence: 99%

Long-term seizure, psychiatric and socioeconomic outcomes after frontal lobe epilepsy surgery

et al. 2022

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Simultaneous 18F-FDG PET/MRI predicting favourable surgical outcome in refractory epilepsy patients

Guo,

Hu,

Cui

et al. 2024

Neuroradiology

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Seizure outcome after epilepsy surgery for patients with normal MRI: A Single center experience

Cited by 4 publications

References 27 publications

Twenty‐five years of epilepsy surgery at a Central European comprehensive epilepsy center—Trends in intervention delay and outcomes

Twenty‐five years of epilepsy surgery at a Central European comprehensive epilepsy center—Trends in intervention delay and outcomes

Long-term seizure, psychiatric and socioeconomic outcomes after frontal lobe epilepsy surgery

Simultaneous 18F-FDG PET/MRI predicting favourable surgical outcome in refractory epilepsy patients

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