Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors

Veronica Pelliccia, Francesco Deleo, Francesca Gozzo, Ivana Sartori, Roberto Mai, Massimo Cossu, Laura Tassi

Research output: Contribution to journalArticle

Abstract

OBJECTIVE Epilepsy surgery is an effective means of treating focal epilepsy associated with long-term epilepsy-associated tumors. This study evaluated a large population of surgically treated patients with childhood onset of epilepsy and a histologically confirmed diagnosis of long-term epilepsy-associated tumors. The authors analyzed long-term seizure outcomes to establish whether the time of surgery and patients' ages were determinant factors. METHODS The authors separately investigated several presurgical, surgical, and postsurgical variables in patients operated on before (pediatric group) and at or after (adult group) the age of 18 years. Patients with < 24 months of postsurgical follow-up were excluded from the analysis. RESULTS The patients who underwent surgery before 18 years of age showed better seizure outcomes than those after 18 years of age (80% vs 53.3% Engel Class Ia outcome, respectively; p < 0.001). Multivariate analysis showed that the only variables significantly associated with seizure freedom were complete resection of the lesion, a shorter duration of epilepsy, and temporal lobe resection. CONCLUSIONS The findings of this study indicate that pediatric patients are more responsive to epilepsy surgery and that a shorter duration of epilepsy, complete resection, and a temporal lobe localization are determinant factors for a positive seizure outcome.

Original languageEnglish
Pages (from-to)1147-1152
Number of pages6
JournalJournal of Neurosurgery
Volume127
Issue number5
DOIs
Publication statusPublished - Nov 1 2017

Keywords

  • Brain MRI
  • Epilepsy surgery
  • Focal symptomatic epilepsy
  • Long-term epilepsy-associated tumors

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Pelliccia, V., Deleo, F., Gozzo, F., Sartori, I., Mai, R., Cossu, M., & Tassi, L. (2017). Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors. Journal of Neurosurgery, 127(5), 1147-1152. https://doi.org/10.3171/2016.9.JNS161176