Seizure outcomes in children with epilepsy after resective brain surgery

Nagarajan, Lakshmi; Lee, Michael; Palumbo, Linda; Lee, Sharon; Shah, Snehal; Walsh, Peter; Cannell, Patricia; Ghosh, Soumya

doi:10.1016/j.ejpn.2015.05.006

Cited by 13 publications

(6 citation statements)

References 44 publications

(20 reference statements)

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“…Conversely, some studies failed to identify any significant differences between the seizure outcome and severity of histopathology [15,35,57]. Compared with FCD, glio-neuronal tumors are known to have greater favorable outcomes [12,14,37,52]. Furthermore, glioneuronal tumors associated with FCDs (FCD IIIa) showed excellent outcome compared with FCD type I, which was comparable to solitary tumors [11].…”

Section: Prognostic Factors Of Favorable Outcomementioning

confidence: 99%

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

Choi

Kim

2019

J Korean Neurosurg Soc

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Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50–75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts’ characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

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Section: Prognostic Factors Of Favorable Outcomementioning

confidence: 99%

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

Choi

Kim

2019

J Korean Neurosurg Soc

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“…The decision to undertake a temporal lobectomy in this case was challenging, and her parents played an integral role. In our experience [20] 76% of children with seizures and resective brain surgery have become seizure-free (Engel class 1) on long term follow up. A Cochrane review regarding surgery for epilepsy concluded that seizure freedom was seen in 64% of cases; however, the range of success varied from 13.5 to 92.5% [41] .…”

Section: Discussionmentioning

confidence: 75%

Epilepsy surgery in PCDH 19 related developmental and epileptic encephalopathy: A case report

Nagarajan

Ghosh

Dyke

et al. 2022

Epilepsy & Behavior Reports

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“…The titles/abstracts of each were screened against the study inclusion criteria, leading to the identification of 96 records for further screening, of which 7 could not be located. After a full-text review, 31 studies 11,22-51 were included in the present analysis (Table 1). Across studies, a total of 1206 patients with complete follow-up and outcome data were included, of whom 830 (68.82%) underwent ECoG-guided resection.…”

Section: Resultsmentioning

confidence: 99%

Electrocorticography-Guided Resection Enhances Postoperative Seizure Freedom in Low-Grade Tumor-Associated Epilepsy: A Systematic Review and Meta-Analysis

et al. 2022

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BACKGROUND: Low-grade cerebral neoplasms are commonly associated with medically intractable epilepsy. Despite increasing evidence that epileptogenic brain regions commonly extend beyond visible tumor margins, the utility of extended surgical resections leveraging intraoperative electrocorticography (ECoG) remains unclear. OBJECTIVE: To determine whether ECoG-guided surgery is associated with improved postoperative seizure control. METHODS: We performed a systematic review and meta-analysis encompassing both adult and pediatric populations. The primary outcome measure was postoperative seizure freedom as defined by Engel class I outcome. Class I/II outcome served as a secondary measure. Relevant clinical and operative data were recorded. A random-effects metaanalysis based on the pooled odds ratio (OR) of seizure freedom was performed on studies that reported comparative data between ECoG-guided surgery and lesionectomy. RESULTS: A total of 31 studies encompassing 1115 patients with medically refractory epilepsy met inclusion criteria. Seven studies reported comparative data between ECoGguided surgery and lesionectomy for meta-analysis. Tumor resection guided by ECoG was associated with significantly greater postoperative seizure freedom (OR 3.95, 95% CI 2.32-6.72, P < .0001) and class I/II outcome (OR 5.10, 95% CI 1.97-13.18, P = .0008) compared with lesionectomy. Postoperative adverse events were rare in both groups. CONCLUSION: These findings provide support for the utilization of ECoG-guided surgery to improve postoperative seizure freedom in cases of refractory epilepsy associated with low-grade neoplasms. However, this effect may be attenuated in the presence of concomitant cortical dysplasia, highlighting a need for improved presurgical and intraoperative monitoring for these most challenging cases of localization-related epilepsy.

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Seizure outcomes in children with epilepsy after resective brain surgery

Cited by 13 publications

References 44 publications

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

Epilepsy surgery in PCDH 19 related developmental and epileptic encephalopathy: A case report

Electrocorticography-Guided Resection Enhances Postoperative Seizure Freedom in Low-Grade Tumor-Associated Epilepsy: A Systematic Review and Meta-Analysis

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