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    The Irish epilepsy surgery experience: Long-term follow-up.

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    Authors
    Dunlea, Orla
    Doherty, Colin P
    Farrell, Michael
    Fitzsimons, Mary
    O'Brien, Donncha
    Murphy, Kevin
    MacMackin, Deirdre
    Pender, Niall
    Staunton, Hugh
    Phillips, Jack
    Delanty, Norman
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    Affiliation
    Department of Neurology, Beaumont Hospital, Dublin 9, Ireland. odunlea@hotmail.com
    Issue Date
    2010-05
    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
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    Citation
    The Irish epilepsy surgery experience: Long-term follow-up. 2010, 19 (4):247-52 Seizure
    Journal
    Seizure : the journal of the British Epilepsy Association
    URI
    http://hdl.handle.net/10147/127109
    DOI
    10.1016/j.seizure.2010.03.001
    PubMed ID
    20359911
    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.
    Item Type
    Article
    Language
    en
    ISSN
    1532-2688
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.seizure.2010.03.001
    Scopus Count
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    Beaumont Hospital

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