Predictors of seizure outcome after temporal lobectomy for intractable epilepsy
Abstract:Stavem K, Bjørnæs H, Langmoen IA. Predictors of seizure outcome after temporal lobectomy for intractable epilepsy.
Acta Neurol Scand 2004: 109: 244–249. © Blackwell Munksgaard 2003. Objectives –
To assess predictors of outcome of temporal lobectomy for intractable epilepsy. Material and methods –
In 63 adult patients operated with anterior temporal lobectomy during 1988–92, we used logistic regression analysis to assess predictors of being seizure-free (Engel's class I) 2 years after surgery. As potential predictors, we included the following variables: gender, age at operation, age at onset of seizures, epilepsy duration, etiology, generalized vs not generalized seizures, seizure frequency, intelligence quotient, ictal electroencephalography, magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT) , side of resection, and extent of the resection. Results –
About 44% of the surgery patients were seizure-free (Engel's class I) 2 years after surgery. In multivariate analysis (n = 55), MRI pathology defined as atrophy in the temporal lobe, angioma, tumor or mesial temporal sclerosis (odds ratio, OR 7.4, 95%CI: 1.7–32.9) and extent of the hippocampal resection (increase of 1 cm) (OR 2.2, 95%CI: 1.1–4.6) predicted being seizure-free. Conclusion –
Focal pathology in preoperative MRI and the extent of the hippocampal resection were the only significant predictors of being seizure-free after 2 years.