Outcome of epilepsy surgery in lesional epilepsy: Experiences from a developing country
•The resective surgery delivers an excellent outcome for intractable epilepsy.•Trained staff, video-EEG monitoring, and MRI technology affect surgery outcome.•Temporal lesion, CNS infection, and ECoG were predictors of a favorable outcome.•Normal postoperative EEG is a strong positive outcome predic...
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| Veröffentlicht in: | Epilepsy & behavior 2021-09, Vol.122, p.108221-108221, Article 108221 |
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| creator | Mehvari Habibabadi, Jafar Moein, Houshang Jourahmad, Zahra Ahmadian, Mana Basiratnia, Reza Zare, Mohammad Hashemi Fesharaki, Seyed Sohrab Badihian, Shervin Barekatain, Majid Tabrizi, Nasim |
| description | •The resective surgery delivers an excellent outcome for intractable epilepsy.•Trained staff, video-EEG monitoring, and MRI technology affect surgery outcome.•Temporal lesion, CNS infection, and ECoG were predictors of a favorable outcome.•Normal postoperative EEG is a strong positive outcome predictor.
Our aim was to report the postoperative seizure outcome and associated factors in patients with lesional epilepsy, in a low-income setting.
This longitudinal prospective study included patients who underwent epilepsy surgery at Kashani Comprehensive Epilepsy Center between 2014 and 2019. Post-surgical outcomes were reported according to the Engel score, and patients were classified into two groups of seizure free (SF) and not-seizure free (NSF).
A total of 148 adult patients, with a mean age of 30.45 ± 9.23 years were included. The SF outcome was reported in 86.5% of patients and antiepileptic drugs (AEDs) were reduced or discontinued in 45.9%. The mean follow-up duration was 26.7 ± 14.9 months. Temporal lobe lesions (76.3%) and mesial temporal sclerosis (MTS) (56.7%) were the most frequent etiologies. Temporal lesion (Incidence relative risk (IRR): 1.76, 95% CI [1.08–2.87], p = 0.023), prior history of CNS infection (IRR:1.18, 95% CI [1.03–1.35], p = 0.019), use of intra-operative ECoG (IRR:1.73, 95% CI [1.06–2.81], p = 0.028), and absence of IEDs in postoperative EEG (IRR: 1.41, 95% CI [1.18–1.70], p |
| doi_str_mv | 10.1016/j.yebeh.2021.108221 |
| format | Article |
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Our aim was to report the postoperative seizure outcome and associated factors in patients with lesional epilepsy, in a low-income setting.
This longitudinal prospective study included patients who underwent epilepsy surgery at Kashani Comprehensive Epilepsy Center between 2014 and 2019. Post-surgical outcomes were reported according to the Engel score, and patients were classified into two groups of seizure free (SF) and not-seizure free (NSF).
A total of 148 adult patients, with a mean age of 30.45 ± 9.23 years were included. The SF outcome was reported in 86.5% of patients and antiepileptic drugs (AEDs) were reduced or discontinued in 45.9%. The mean follow-up duration was 26.7 ± 14.9 months. Temporal lobe lesions (76.3%) and mesial temporal sclerosis (MTS) (56.7%) were the most frequent etiologies. Temporal lesion (Incidence relative risk (IRR): 1.76, 95% CI [1.08–2.87], p = 0.023), prior history of CNS infection (IRR:1.18, 95% CI [1.03–1.35], p = 0.019), use of intra-operative ECoG (IRR:1.73, 95% CI [1.06–2.81], p = 0.028), and absence of IEDs in postoperative EEG (IRR: 1.41, 95% CI [1.18–1.70], p < 0.001) were positive predictors for a favorable outcome.
Many patients with drug-resistant lesional epilepsy showed a favorable response to surgery. We believe that resective epilepsy surgery in low-income settings is a major treatment option. The high frequency of patients with drug-resistant epilepsy in developing countries is associated with high rates of morbidity and mortality. Hence, strategies to increase access to epilepsy surgery in these settings are urgently needed.</description><identifier>ISSN: 1525-5050</identifier><identifier>EISSN: 1525-5069</identifier><identifier>DOI: 10.1016/j.yebeh.2021.108221</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>Epilepsy surgery outcome ; Epilepsy surgery prognostic factors ; Lesional epilepsy ; Resource-limited setting</subject><ispartof>Epilepsy & behavior, 2021-09, Vol.122, p.108221-108221, Article 108221</ispartof><rights>2021 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c336t-b13112ecbd059dee2cc93efd3d1f188ff1c1a0920565f4e4b721c487e0ca1f783</citedby><cites>FETCH-LOGICAL-c336t-b13112ecbd059dee2cc93efd3d1f188ff1c1a0920565f4e4b721c487e0ca1f783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.yebeh.2021.108221$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids></links><search><creatorcontrib>Mehvari Habibabadi, Jafar</creatorcontrib><creatorcontrib>Moein, Houshang</creatorcontrib><creatorcontrib>Jourahmad, Zahra</creatorcontrib><creatorcontrib>Ahmadian, Mana</creatorcontrib><creatorcontrib>Basiratnia, Reza</creatorcontrib><creatorcontrib>Zare, Mohammad</creatorcontrib><creatorcontrib>Hashemi Fesharaki, Seyed Sohrab</creatorcontrib><creatorcontrib>Badihian, Shervin</creatorcontrib><creatorcontrib>Barekatain, Majid</creatorcontrib><creatorcontrib>Tabrizi, Nasim</creatorcontrib><title>Outcome of epilepsy surgery in lesional epilepsy: Experiences from a developing country</title><title>Epilepsy & behavior</title><description>•The resective surgery delivers an excellent outcome for intractable epilepsy.•Trained staff, video-EEG monitoring, and MRI technology affect surgery outcome.•Temporal lesion, CNS infection, and ECoG were predictors of a favorable outcome.•Normal postoperative EEG is a strong positive outcome predictor.
Our aim was to report the postoperative seizure outcome and associated factors in patients with lesional epilepsy, in a low-income setting.
This longitudinal prospective study included patients who underwent epilepsy surgery at Kashani Comprehensive Epilepsy Center between 2014 and 2019. Post-surgical outcomes were reported according to the Engel score, and patients were classified into two groups of seizure free (SF) and not-seizure free (NSF).
A total of 148 adult patients, with a mean age of 30.45 ± 9.23 years were included. The SF outcome was reported in 86.5% of patients and antiepileptic drugs (AEDs) were reduced or discontinued in 45.9%. The mean follow-up duration was 26.7 ± 14.9 months. Temporal lobe lesions (76.3%) and mesial temporal sclerosis (MTS) (56.7%) were the most frequent etiologies. Temporal lesion (Incidence relative risk (IRR): 1.76, 95% CI [1.08–2.87], p = 0.023), prior history of CNS infection (IRR:1.18, 95% CI [1.03–1.35], p = 0.019), use of intra-operative ECoG (IRR:1.73, 95% CI [1.06–2.81], p = 0.028), and absence of IEDs in postoperative EEG (IRR: 1.41, 95% CI [1.18–1.70], p < 0.001) were positive predictors for a favorable outcome.
Many patients with drug-resistant lesional epilepsy showed a favorable response to surgery. We believe that resective epilepsy surgery in low-income settings is a major treatment option. The high frequency of patients with drug-resistant epilepsy in developing countries is associated with high rates of morbidity and mortality. Hence, strategies to increase access to epilepsy surgery in these settings are urgently needed.</description><subject>Epilepsy surgery outcome</subject><subject>Epilepsy surgery prognostic factors</subject><subject>Lesional epilepsy</subject><subject>Resource-limited setting</subject><issn>1525-5050</issn><issn>1525-5069</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE1PwzAMhiMEEmPwC7jkyGUjTpquReKApvEhTdoFxDFqU2dkapuStBP993Qr2pGTLduvpech5BbYHBjE97t5jzl-zTnjMEwSzuGMTEByOZMsTs9PvWSX5CqEHWMAUsCEfG66VrsKqTMUG1tiE3oaOr9F31Nb0xKDdXVWnpYPdPXToLdYawzUeFfRjBa4x9I1tt5S7bq69f01uTBZGfDmr07Jx_Pqffk6W29e3pZP65kWIm5nOQgAjjovmEwLRK51KtAUogADSWIMaMhYypmMpYkwyhccdJQskOkMzCIRU3I3_m28--4wtKqyQWNZZjW6LiguZRqJKBlop0SMp9q7EDwa1XhbZb5XwNRBo9qpo0Z10KhGjUPqcUzhQLG36FXQR_jCetStKpz9N_8L-V19rA</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Mehvari Habibabadi, Jafar</creator><creator>Moein, Houshang</creator><creator>Jourahmad, Zahra</creator><creator>Ahmadian, Mana</creator><creator>Basiratnia, Reza</creator><creator>Zare, Mohammad</creator><creator>Hashemi Fesharaki, Seyed Sohrab</creator><creator>Badihian, Shervin</creator><creator>Barekatain, Majid</creator><creator>Tabrizi, Nasim</creator><general>Elsevier Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202109</creationdate><title>Outcome of epilepsy surgery in lesional epilepsy: Experiences from a developing country</title><author>Mehvari Habibabadi, Jafar ; Moein, Houshang ; Jourahmad, Zahra ; Ahmadian, Mana ; Basiratnia, Reza ; Zare, Mohammad ; Hashemi Fesharaki, Seyed Sohrab ; Badihian, Shervin ; Barekatain, Majid ; Tabrizi, Nasim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c336t-b13112ecbd059dee2cc93efd3d1f188ff1c1a0920565f4e4b721c487e0ca1f783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Epilepsy surgery outcome</topic><topic>Epilepsy surgery prognostic factors</topic><topic>Lesional epilepsy</topic><topic>Resource-limited setting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mehvari Habibabadi, Jafar</creatorcontrib><creatorcontrib>Moein, Houshang</creatorcontrib><creatorcontrib>Jourahmad, Zahra</creatorcontrib><creatorcontrib>Ahmadian, Mana</creatorcontrib><creatorcontrib>Basiratnia, Reza</creatorcontrib><creatorcontrib>Zare, Mohammad</creatorcontrib><creatorcontrib>Hashemi Fesharaki, Seyed Sohrab</creatorcontrib><creatorcontrib>Badihian, Shervin</creatorcontrib><creatorcontrib>Barekatain, Majid</creatorcontrib><creatorcontrib>Tabrizi, Nasim</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Epilepsy & behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehvari Habibabadi, Jafar</au><au>Moein, Houshang</au><au>Jourahmad, Zahra</au><au>Ahmadian, Mana</au><au>Basiratnia, Reza</au><au>Zare, Mohammad</au><au>Hashemi Fesharaki, Seyed Sohrab</au><au>Badihian, Shervin</au><au>Barekatain, Majid</au><au>Tabrizi, Nasim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of epilepsy surgery in lesional epilepsy: Experiences from a developing country</atitle><jtitle>Epilepsy & behavior</jtitle><date>2021-09</date><risdate>2021</risdate><volume>122</volume><spage>108221</spage><epage>108221</epage><pages>108221-108221</pages><artnum>108221</artnum><issn>1525-5050</issn><eissn>1525-5069</eissn><abstract>•The resective surgery delivers an excellent outcome for intractable epilepsy.•Trained staff, video-EEG monitoring, and MRI technology affect surgery outcome.•Temporal lesion, CNS infection, and ECoG were predictors of a favorable outcome.•Normal postoperative EEG is a strong positive outcome predictor.
Our aim was to report the postoperative seizure outcome and associated factors in patients with lesional epilepsy, in a low-income setting.
This longitudinal prospective study included patients who underwent epilepsy surgery at Kashani Comprehensive Epilepsy Center between 2014 and 2019. Post-surgical outcomes were reported according to the Engel score, and patients were classified into two groups of seizure free (SF) and not-seizure free (NSF).
A total of 148 adult patients, with a mean age of 30.45 ± 9.23 years were included. The SF outcome was reported in 86.5% of patients and antiepileptic drugs (AEDs) were reduced or discontinued in 45.9%. The mean follow-up duration was 26.7 ± 14.9 months. Temporal lobe lesions (76.3%) and mesial temporal sclerosis (MTS) (56.7%) were the most frequent etiologies. Temporal lesion (Incidence relative risk (IRR): 1.76, 95% CI [1.08–2.87], p = 0.023), prior history of CNS infection (IRR:1.18, 95% CI [1.03–1.35], p = 0.019), use of intra-operative ECoG (IRR:1.73, 95% CI [1.06–2.81], p = 0.028), and absence of IEDs in postoperative EEG (IRR: 1.41, 95% CI [1.18–1.70], p < 0.001) were positive predictors for a favorable outcome.
Many patients with drug-resistant lesional epilepsy showed a favorable response to surgery. We believe that resective epilepsy surgery in low-income settings is a major treatment option. The high frequency of patients with drug-resistant epilepsy in developing countries is associated with high rates of morbidity and mortality. Hence, strategies to increase access to epilepsy surgery in these settings are urgently needed.</abstract><pub>Elsevier Inc</pub><doi>10.1016/j.yebeh.2021.108221</doi><tpages>1</tpages></addata></record> |
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| subjects | Epilepsy surgery outcome Epilepsy surgery prognostic factors Lesional epilepsy Resource-limited setting |
| title | Outcome of epilepsy surgery in lesional epilepsy: Experiences from a developing country |
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