Predictors of Postoperative Seizure Recurrence: A Longitudinal Study of Temporal and Extratemporal Resections. Academic Article uri icon

Overview

abstract

  • Objective. We investigated the longitudinal outcome of resective epilepsy surgery to identify the predictors of seizure recurrence. Materials and Methods. We retrospectively analyzed patients who underwent resections for intractable epilepsy over a period of 7 years. Multiple variables were investigated as potential predictors of seizure recurrence. The time to first postoperative seizure was evaluated using survival analysis and univariate analysis at annual intervals. Results. Among 70 patients, 54 (77%) had temporal and 16 (23%) had extratemporal resections. At last follow-up (mean 48 months; range 24-87 months), the outcome was Engel class I in 84% (n = 59) of patients. Seizure recurrence followed two patterns: recurrence was "early" (within 2 years) in 82% of patients, of whom 83% continued to have seizures despite optimum medical therapy; recurrence was "late" (after 2 years) in 18%, of whom 25% continued to have seizures subsequently. Among the variables of interest, only resection site and ictal EEG remained as independent predictors of seizure recurrence over the long term (p < 0.05). Extratemporal resection and discordance between ictal EEG and resection area were associated with 4.2-fold and 5.6-fold higher risk of seizure recurrence, respectively. Conclusions. Extratemporal epilepsy and uncertainty in ictal EEG localization are independent predictors of unfavorable outcome. Seizure recurrence within two years of surgery indicates poor long-term outcome.

authors

  • Chen, Hai
  • Modur, Pradeep N
  • Barot, Niravkumar
  • Van Ness, Paul C
  • Agostini, Mark A
  • Ding, Kan
  • Gupta, Puneet
  • Hays, Ryan
  • Mickey, Bruce

publication date

  • March 16, 2016

Identity

PubMed Central ID

  • PMC4812270

Scopus Document Identifier

  • 85020147901

Digital Object Identifier (DOI)

  • 10.1155/2016/7982494

PubMed ID

  • 27069682

Additional Document Info

volume

  • 2016