Prognostic factors for surgery of neocortical temporal lobe epilepsy

J. Janszky, H. W. Pannek, A. Fogarasi, B. Bone, R. Schulz, F. Behne, A. Ebner

Research output: Article

27 Citations (Scopus)

Abstract

Objectives: In the current classification of epilepsies two forms of temporal lobe epilepsy (TLE) were included: mesial and lateral (neocortical) TLE. We aimed at identifying prognostic factors for the surgical outcome of lesional neocortical TLE. Methods: We included consecutive patients who had undergone presurgical evaluation including ictal video-EEG and high-resolution MRI, who had TLE due to neocortical lateral epileptogenic lesions, who had a lesionectomy and who had >2-year follow-up. Results: There were 29 patients who met the inclusion criteria. Twenty of them became postoperatively seizure-free. Patients' mean age was 34.8 ± 9 years (range 18-52). The age at epilepsy onset was 20.1 ± 8 years. We found that left-sided surgery (p = 0.048) and focal cortical dysplasia (FCD) on MRI (p = 0.005) were associated with non-seizure-free outcome, while lateralized/localized EEG seizure pattern (p = 0.032), tumors on the MRI (p = 0.013), and a favorable seizure situation at the 6-month postoperative evaluation were associated with 2-year postoperative seizure-freedom (p <0.001). Multivariate analysis indicated that the side of surgery was not an independent predictor. Conclusion: More than two-thirds of the patients with neocortical TLE became seizure-free postoperatively. Lateralized/localized EEG seizure pattern and tumors on the MRI were associated with postoperative seizure-freedom, while FCD were associated with a poor outcome. The 6-month postoperative outcome is a reliable predictor for the long-term outcome.

Original languageEnglish
Pages (from-to)125-132
Number of pages8
JournalSeizure
Volume15
Issue number2
DOIs
Publication statusPublished - márc. 2006

Fingerprint

Temporal Lobe Epilepsy
Seizures
Malformations of Cortical Development
Electroencephalography
Epilepsy
Age of Onset
Neoplasms
Multivariate Analysis
Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Psychology(all)

Cite this

Prognostic factors for surgery of neocortical temporal lobe epilepsy. / Janszky, J.; Pannek, H. W.; Fogarasi, A.; Bone, B.; Schulz, R.; Behne, F.; Ebner, A.

In: Seizure, Vol. 15, No. 2, 03.2006, p. 125-132.

Research output: Article

Janszky, J. ; Pannek, H. W. ; Fogarasi, A. ; Bone, B. ; Schulz, R. ; Behne, F. ; Ebner, A. / Prognostic factors for surgery of neocortical temporal lobe epilepsy. In: Seizure. 2006 ; Vol. 15, No. 2. pp. 125-132.
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abstract = "Objectives: In the current classification of epilepsies two forms of temporal lobe epilepsy (TLE) were included: mesial and lateral (neocortical) TLE. We aimed at identifying prognostic factors for the surgical outcome of lesional neocortical TLE. Methods: We included consecutive patients who had undergone presurgical evaluation including ictal video-EEG and high-resolution MRI, who had TLE due to neocortical lateral epileptogenic lesions, who had a lesionectomy and who had >2-year follow-up. Results: There were 29 patients who met the inclusion criteria. Twenty of them became postoperatively seizure-free. Patients' mean age was 34.8 ± 9 years (range 18-52). The age at epilepsy onset was 20.1 ± 8 years. We found that left-sided surgery (p = 0.048) and focal cortical dysplasia (FCD) on MRI (p = 0.005) were associated with non-seizure-free outcome, while lateralized/localized EEG seizure pattern (p = 0.032), tumors on the MRI (p = 0.013), and a favorable seizure situation at the 6-month postoperative evaluation were associated with 2-year postoperative seizure-freedom (p <0.001). Multivariate analysis indicated that the side of surgery was not an independent predictor. Conclusion: More than two-thirds of the patients with neocortical TLE became seizure-free postoperatively. Lateralized/localized EEG seizure pattern and tumors on the MRI were associated with postoperative seizure-freedom, while FCD were associated with a poor outcome. The 6-month postoperative outcome is a reliable predictor for the long-term outcome.",
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AU - Pannek, H. W.

AU - Fogarasi, A.

AU - Bone, B.

AU - Schulz, R.

AU - Behne, F.

AU - Ebner, A.

PY - 2006/3

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N2 - Objectives: In the current classification of epilepsies two forms of temporal lobe epilepsy (TLE) were included: mesial and lateral (neocortical) TLE. We aimed at identifying prognostic factors for the surgical outcome of lesional neocortical TLE. Methods: We included consecutive patients who had undergone presurgical evaluation including ictal video-EEG and high-resolution MRI, who had TLE due to neocortical lateral epileptogenic lesions, who had a lesionectomy and who had >2-year follow-up. Results: There were 29 patients who met the inclusion criteria. Twenty of them became postoperatively seizure-free. Patients' mean age was 34.8 ± 9 years (range 18-52). The age at epilepsy onset was 20.1 ± 8 years. We found that left-sided surgery (p = 0.048) and focal cortical dysplasia (FCD) on MRI (p = 0.005) were associated with non-seizure-free outcome, while lateralized/localized EEG seizure pattern (p = 0.032), tumors on the MRI (p = 0.013), and a favorable seizure situation at the 6-month postoperative evaluation were associated with 2-year postoperative seizure-freedom (p <0.001). Multivariate analysis indicated that the side of surgery was not an independent predictor. Conclusion: More than two-thirds of the patients with neocortical TLE became seizure-free postoperatively. Lateralized/localized EEG seizure pattern and tumors on the MRI were associated with postoperative seizure-freedom, while FCD were associated with a poor outcome. The 6-month postoperative outcome is a reliable predictor for the long-term outcome.

AB - Objectives: In the current classification of epilepsies two forms of temporal lobe epilepsy (TLE) were included: mesial and lateral (neocortical) TLE. We aimed at identifying prognostic factors for the surgical outcome of lesional neocortical TLE. Methods: We included consecutive patients who had undergone presurgical evaluation including ictal video-EEG and high-resolution MRI, who had TLE due to neocortical lateral epileptogenic lesions, who had a lesionectomy and who had >2-year follow-up. Results: There were 29 patients who met the inclusion criteria. Twenty of them became postoperatively seizure-free. Patients' mean age was 34.8 ± 9 years (range 18-52). The age at epilepsy onset was 20.1 ± 8 years. We found that left-sided surgery (p = 0.048) and focal cortical dysplasia (FCD) on MRI (p = 0.005) were associated with non-seizure-free outcome, while lateralized/localized EEG seizure pattern (p = 0.032), tumors on the MRI (p = 0.013), and a favorable seizure situation at the 6-month postoperative evaluation were associated with 2-year postoperative seizure-freedom (p <0.001). Multivariate analysis indicated that the side of surgery was not an independent predictor. Conclusion: More than two-thirds of the patients with neocortical TLE became seizure-free postoperatively. Lateralized/localized EEG seizure pattern and tumors on the MRI were associated with postoperative seizure-freedom, while FCD were associated with a poor outcome. The 6-month postoperative outcome is a reliable predictor for the long-term outcome.

KW - Benign tumor

KW - EEG seizure pattern

KW - Epilepsy surgery outcome

KW - Left

KW - Prognosis

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