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The Irish epilepsy surgery experience: Long-term follow-up.
Dunlea, Orla Doherty, Colin P Farrell, Michael Fitzsimons, Mary O'Brien, Donncha Murphy, Kevin MacMackin, Deirdre Pender, Niall Staunton, Hugh Phillips, Jack
Dunlea, Orla
Doherty, Colin P
Farrell, Michael
Fitzsimons, Mary
O'Brien, Donncha
Murphy, Kevin
MacMackin, Deirdre
Pender, Niall
Staunton, Hugh
Phillips, Jack
Advisors
Editors
Other Contributors
Date
2010-05
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adolescent
Adult
Anterior Temporal Lobectomy
Child
Child, Preschool
Epilepsy
Female
Follow-Up Studies
Humans
Infant
Ireland
Male
Middle Aged
Neurosurgical Procedures
Retrospective Studies
Seizures
Treatment Outcome
Young Adult
Adult
Anterior Temporal Lobectomy
Child
Child, Preschool
Epilepsy
Female
Follow-Up Studies
Humans
Infant
Ireland
Male
Middle Aged
Neurosurgical Procedures
Retrospective Studies
Seizures
Treatment Outcome
Young Adult
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
To assess the long-term seizure outcome of Irish patients who underwent resective surgery for refractory epilepsy since 1975. We also wished to determine the impact of pathology and surgical technique (with particular reference to neocorticectomy) on seizure outcome.
A retrospective review of medical notes, radiological and histopathological records, was undertaken between 1975 and 2005. Missing data was supplemented by telephone calls to patients. One hundred and ninety-nine patients suited the criteria for inclusion and had at least 1-year follow-up (1-24 years, mean 7.0 years). Engel's criteria were used to classify seizure outcome at 1, 2, 5, 10, 15 and >15 years follow-up.
The percentage of patients seizure free at 2, 5, 10, 15 and >15 years were, 56.6%, 41.4%, 44%, 25% and 31.3%, respectively. Of patients with a pathologically confirmed diagnosis of mesial temporal sclerosis, 55.6% were seizure free at 10 years. Equivalent figures for tumour were 62.5%, for cortical dysplasia, 34.8%, for those without any demonstrable pathologic abnormality, 50%, for dual pathology, 50% and for all others, 33.3%. Of those with 10 years or greater follow-up only 20% of neocorticectomy patients were in Engel class 1, compared with an average of 58.5% for the other surgical techniques.
Seizure freedom rates for Irish Patients were comparable to other large retrospective studies. Patients who underwent selective procedures tended to do better than those undergoing lobar resections, in keeping with international trends. The surgical technique unique to the Irish cohort, temporal necocorticectomy, had the worst long-term outcome.
A retrospective review of medical notes, radiological and histopathological records, was undertaken between 1975 and 2005. Missing data was supplemented by telephone calls to patients. One hundred and ninety-nine patients suited the criteria for inclusion and had at least 1-year follow-up (1-24 years, mean 7.0 years). Engel's criteria were used to classify seizure outcome at 1, 2, 5, 10, 15 and >15 years follow-up.
The percentage of patients seizure free at 2, 5, 10, 15 and >15 years were, 56.6%, 41.4%, 44%, 25% and 31.3%, respectively. Of patients with a pathologically confirmed diagnosis of mesial temporal sclerosis, 55.6% were seizure free at 10 years. Equivalent figures for tumour were 62.5%, for cortical dysplasia, 34.8%, for those without any demonstrable pathologic abnormality, 50%, for dual pathology, 50% and for all others, 33.3%. Of those with 10 years or greater follow-up only 20% of neocorticectomy patients were in Engel class 1, compared with an average of 58.5% for the other surgical techniques.
Seizure freedom rates for Irish Patients were comparable to other large retrospective studies. Patients who underwent selective procedures tended to do better than those undergoing lobar resections, in keeping with international trends. The surgical technique unique to the Irish cohort, temporal necocorticectomy, had the worst long-term outcome.
Language
en
ISSN
1532-2688
eISSN
ISBN
DOI
10.1016/j.seizure.2010.03.001
PMID
20359911