Somatic complications of epilepsy surgery over 25 years at a single center

Gooneratne, Inuka Kishara; Mannan, Shahidul; Tisi, Jane de; García-Arriaza, Juan; McEvoy, Andrew W.; Miserocchi, Anna; Diehl, Beate; Wehner, Tim; Bell, Gail S.; Sander, Josemir W.; Duncan, John S.

doi:10.1016/j.eplepsyres.2017.02.016

Cited by 29 publications

(25 citation statements)

References 34 publications

(41 reference statements)

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“…Complications of surgery are a very important aspect of outcome that we considered in our 1990–2008 cohort3 and more recently for the 1990–2014 cohort 31…”

Section: Discussionmentioning

confidence: 99%

Factors affecting seizure outcome after epilepsy surgery: an observational series

Bell

Tisi

Gonzalez-Fraile

et al. 2017

J Neurol Neurosurg Psychiatry

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“…Complications of surgery are a very important aspect of outcome that we considered in our 1990–2008 cohort3 and more recently for the 1990–2014 cohort 31…”

Section: Discussionmentioning

confidence: 99%

Factors affecting seizure outcome after epilepsy surgery: an observational series

Bell

Tisi

Gonzalez-Fraile

et al. 2017

J Neurol Neurosurg Psychiatry

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“…The most common type of epilepsy surgery is anterior temporal lobe resection, in which the amygdala, anterior hippocampus, and anterior temporal neocortex are removed. The commonest neurological sequelae of temporal lobe surgery are memory impairment, visual field deficits and word-finding difficulties ( Jutila et al, 2002 ; Gooneratne et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

The impact of epilepsy surgery on the structural connectome and its relation to outcome

Taylor

Sinha

Wang

et al. 2018

NeuroImage: Clinical

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BackgroundTemporal lobe surgical resection brings seizure remission in up to 80% of patients, with long-term complete seizure freedom in 41%. However, it is unclear how surgery impacts on the structural white matter network, and how the network changes relate to seizure outcome.MethodsWe used white matter fibre tractography on preoperative diffusion MRI to generate a structural white matter network, and postoperative T1-weighted MRI to retrospectively infer the impact of surgical resection on this network. We then applied graph theory and machine learning to investigate the properties of change between the preoperative and predicted postoperative networks.ResultsTemporal lobe surgery had a modest impact on global network efficiency, despite the disruption caused. This was due to alternative shortest paths in the network leading to widespread increases in betweenness centrality post-surgery. Measurements of network change could retrospectively predict seizure outcomes with 79% accuracy and 65% specificity, which is twice as high as the empirical distribution. Fifteen connections which changed due to surgery were identified as useful for prediction of outcome, eight of which connected to the ipsilateral temporal pole.ConclusionOur results suggest that the use of network change metrics may have clinical value for predicting seizure outcome. This approach could be used to prospectively predict outcomes given a suggested resection mask using preoperative data only.

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“…[ 1 ] The most striking feature that we noticed in our literature review was that there was no consensus on how to classify complications related to epilepsy surgery. Complications were classified as transient or permanent by Gooneratne et al .,[ 2 ] as major or minor by Mathon et al .,[ 5 ] and as minor (transient) or major (permanent) by Tanriverdi et al . [ 7 ] Further, we noted that definitions of major/minor and transient/permanent varied according to the author and a universal scale is neither defined nor used to classify the complications.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there have been several reports mentioning the complications of epilepsy surgery including the ones performed in different epilepsy disorders,[ 2 7 ] complications of both CAH and SelAH,[ 5 ] and complications of only SelAH. [ 10 ] In this report, we aimed to report the complications of CAH procedures only carried out by a single surgeon in one institution to be able to create a more homogeneous patient population.…”

Section: Introductionmentioning

confidence: 99%

Surgical and neurological complications in temporal lobe epilepsy surgery in modern era

Ahmedov¹,

Korkmaz²,

Kemerdere³

et al. 2018

Surg Neurol Int

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Background:Temporal lobe epilepsy is the most common form of focal epilepsy, and surgical treatment has been proven to be an effective and safe management. Despite its safety, it is important to know that some complications and/or even death can be seen after surgery. Neurosurgeons should be able to precisely inform epilepsy surgery candidates about the possible unwanted/unexpected conditions after surgery.Methods:Fifty-three patients who underwent anterior temporal lobe resection due to temporal lobe epilepsy by a single surgeon were investigated retrospectively regarding postoperative surgical and neurological complications.Results:Overall complication rate was found to be 19%, surgical complications comprised 13.2% whereas neurological complications were 5.8%. Three patients underwent a second surgery whereas the rest had medical treatment or recovered spontaneously. Fortunately persistent complication rate was found to be 0%, and there was no mortality.Conclusions:Anterior temporal lobe resection is a safe and very effective surgical modality for the treatment of temporal lobe epilepsy. However, unexpected complications may be possible in this modern era and a surgeon should trust in him/herself not in modern equipments.

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Somatic complications of epilepsy surgery over 25 years at a single center

Cited by 29 publications

References 34 publications

Factors affecting seizure outcome after epilepsy surgery: an observational series

Factors affecting seizure outcome after epilepsy surgery: an observational series

The impact of epilepsy surgery on the structural connectome and its relation to outcome

Surgical and neurological complications in temporal lobe epilepsy surgery in modern era

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