TY - JOUR
T1 - Acute postoperative seizures and long-term seizure outcome after surgery for hippocampal sclerosis
AU - Di Gennaro, Giancarlo
AU - Casciato, Sara
AU - Quarato, Pier Paolo
AU - Mascia, Addolorata
AU - D'aniello, Alfredo
AU - Grammaldo, Liliana G.
AU - Risi, Marco De
AU - Meldolesi, Giulio N.
AU - Romigi, Andrea
AU - Esposito, Vincenzo
AU - Picardi, Angelo
PY - 2015
Y1 - 2015
N2 - Purpose: To assess the incidence and the prognostic value of acute postoperative seizures (APOS) in patients surgically treated for drug-resistant temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS). Methods: We studied 139 consecutive patients with TLE-HS who underwent epilepsy surgery and were followed up for at least 5 years (mean duration of follow-up 9.1 years, range 5-15). Medical charts were reviewed to identify APOS, defined as ictal events with the exception of auras occurring within the first 7 days after surgery. Seizure outcome was determined at annual intervals. Patients who were in Engel Class Ia at the last contact were classified as having a favorable outcome. Results: Seizure outcome was favorable in 99 patients (71%). Six patients (4%) experienced APOS and in all cases their clinical manifestations were similar to the habitual preoperative seizures. All patients with APOS had unfavorable long-term outcome, as compared with 35 (26%) of 133 in whom APOS did not occur (p <0.001). Conclusions: Our study suggests that APOS, despite being relatively uncommon in patients undergoing resective surgery for TLE-HS, are associated with a worse long-term seizure outcome. Given some study limitations, our findings should be regarded as preliminary and need confirmation from future larger, prospective, multicenter studies.
AB - Purpose: To assess the incidence and the prognostic value of acute postoperative seizures (APOS) in patients surgically treated for drug-resistant temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS). Methods: We studied 139 consecutive patients with TLE-HS who underwent epilepsy surgery and were followed up for at least 5 years (mean duration of follow-up 9.1 years, range 5-15). Medical charts were reviewed to identify APOS, defined as ictal events with the exception of auras occurring within the first 7 days after surgery. Seizure outcome was determined at annual intervals. Patients who were in Engel Class Ia at the last contact were classified as having a favorable outcome. Results: Seizure outcome was favorable in 99 patients (71%). Six patients (4%) experienced APOS and in all cases their clinical manifestations were similar to the habitual preoperative seizures. All patients with APOS had unfavorable long-term outcome, as compared with 35 (26%) of 133 in whom APOS did not occur (p <0.001). Conclusions: Our study suggests that APOS, despite being relatively uncommon in patients undergoing resective surgery for TLE-HS, are associated with a worse long-term seizure outcome. Given some study limitations, our findings should be regarded as preliminary and need confirmation from future larger, prospective, multicenter studies.
KW - Acute postoperative seizures
KW - Epilepsy surgery
KW - Hippocampal sclerosis
KW - Outcome
KW - Temporal lobe epilepsy
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U2 - 10.1016/j.seizure.2014.08.007
DO - 10.1016/j.seizure.2014.08.007
M3 - Article
C2 - 25281058
AN - SCOPUS:84927740345
VL - 24
SP - 59
EP - 62
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
SN - 1059-1311
IS - C
ER -