Surgical treatment for patients with symptomatic generalised seizures due to brain lesions

Yu, Tao; Zhang, Guojun; Wang, Yuping; Ni, Duanyu; Qiao, Li; Du, Wenying; Piao, Yuanyuan; Li, Yongjie

doi:10.1016/j.eplepsyres.2015.02.001

Cited by 7 publications

(6 citation statements)

References 24 publications

(26 reference statements)

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“…The proportion of generalized epileptic spasms was less than that of previous studies [11], which might affect statistical results between semiology and surgical outcomes. According to the new guidelines of the ILAE 2017 seizures classification, epileptic spasms were divided into three major categories: focal, generalized and unknown onset [13].…”

Section: Generalized Seizures Could Not Predict the Unfavourable Surgical Outcomecontrasting

confidence: 58%

“…In this study, most epileptic spasms were classified as focal epileptic spasms. Previous studies [11] classified epileptic spasms as generalized seizures, even though asymmetrical epileptic spasms were observed. Focal spasms usually appeared as asymmetric spasms.…”

Section: Generalized Seizures Could Not Predict the Unfavourable Surgical Outcomementioning

confidence: 98%

“…However, other potential factors that might affect seizure outcomes, including seizure semiology [6], have received little attention. It has been previously reported that focal lesions might cause generalized seizures [11,12]. Few studies have focused on generalized seizures in hemispherectomy candidates and whether they are surgical contraindications.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Generalized seizures presurgically in a cohort of children with hemispherectomy: Predictors and a potential link to surgical outcome?

Ming

Liu

et al. 2018

Seizure

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Section: Generalized Seizures Could Not Predict the Unfavourable Surgical Outcomecontrasting

confidence: 58%

Section: Generalized Seizures Could Not Predict the Unfavourable Surgical Outcomementioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Generalized seizures presurgically in a cohort of children with hemispherectomy: Predictors and a potential link to surgical outcome?

Ming

Liu

et al. 2018

Seizure

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“…Resective epilepsy surgery has become an established treatment modality for appropriately selected children and infants with symptomatic focal seizures. 1 Hemispherectomy is an effective treatment for unilateral refractory epilepsy. 2,3 In 1938, McKenzie provided the first description, and in 1950, Krynauw reported the first positive results in seizure outcome.…”

Section: Introductionmentioning

confidence: 99%

The Application of Preoperative Computed Tomography Angiogram for Hemispherectomy

Qiu

Cui

et al. 2017

Clinics and Practice

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Hemispherectomy is an established neurosurgical procedure for unilateral refractory epilepsy . Even though the surgical approach has evolved greatly, prevention of catastrophic intraoperative bleeding is a challenge. It is important that surgeons know the abnormal blood vessel before surgery. Herein, we report our experience with two patients in whom computed tomographic angiography (CTA) was used in the preoperative evaluation for hemispherectomy. CTA allowed for precise anatomical delineation of the hemispheric vascular abnormalities. Preoperative CTA showed that the specific cerebral arteries and their branches ipsilateral to the lesion were slender. Elaborate preoperative planning for the surgical approach helped prevent catastrophic intraoperative bleeding. Favorable outcomes were achieved in both children. CTA appears to confer a considerable advantage in the preoperative vascular and anatomical delineation in patients scheduled for hemispherectomy. To our knowledge, this is the first report about the application of CTA for hemispherectomy preoperative planning.

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“… 1 – 5 In the short term, many single or pooled analyses have reported good seizure outcomes in children with epilepsy following hemispheric surgery; the seizure-free rate (Engel Class I) ranges from 43% to 78%. 6 – 12 Some researchers have conducted long-term follow-ups (more than 5 years); however, most evidence is based on a single study. 13 – 28 Hu et al 29 have pooled a seizure-free rate of 73% from 1528 patients (56 studies) who underwent hemispheric surgery.…”

Section: Introductionmentioning

confidence: 99%

Five-Year Long-Term Prognosis of Epileptic Children After Hemispheric Surgery

et al. 2016

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To estimate children's long-term seizure outcomes after hemispheric surgery and the associated predictors.A systematic review of 4 databases and a meta-analysis were performed from January 1, 1995 to August 31, 2015. The databases included PubMed, Embase, Science Direct, and Web of Science; patients were classified into the Engel Class I group and the Engel Class II to IV group, according to their seizure outcomes. Nine potential predictors were then stratified across the groups and estimated using the Wilcoxon rank-sum test for continuous variables and the Chi-squared test for categorical variables.The search yielded 15 retrospective studies, with a total sample size of 380. Five years after surgery, 268 (0.71, 95% confidence interval [CI]: 0.64–0.78) children were seizure free; the seizure onset age in the Engel Class I group was significantly higher than that of the Engel Class II to IV group (standardized mean difference [SMD] = 0.26, 95% CI: 0.03–0.49, P = 0.028); specifically, when predicting the positive long-term outcomes, the odds ratio for late onset age (≥3.6 months, median value of the Engel Class II–IV group) versus early onset age was 2.65 (95% CI: 1.454–4.836, z = 3.18, P = 0.001). The abnormal magnetic resonance imaging (MRI) findings were more predictive for positive seizure outcomes than the normal findings (odds ratio [OR] = 4.60, 95% CI: 1.27–16.62, P = 0.02).Following hemispheric surgery, the long-term prognosis of children with epilepsy was good. Late seizure onset (age ≥ 3.6 months) and abnormal MRI findings were positive predictors for long-term seizure control in children.

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Surgical treatment for patients with symptomatic generalised seizures due to brain lesions

Cited by 7 publications

References 24 publications

Generalized seizures presurgically in a cohort of children with hemispherectomy: Predictors and a potential link to surgical outcome?

Generalized seizures presurgically in a cohort of children with hemispherectomy: Predictors and a potential link to surgical outcome?

The Application of Preoperative Computed Tomography Angiogram for Hemispherectomy

Five-Year Long-Term Prognosis of Epileptic Children After Hemispheric Surgery

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