J Korean Neurosurg Soc.  2007 May;41(5):283-290.

Seizure Control in Patients with Extratemporal Lobe Epilepsy

Affiliations
  • 1Department of Neurosurgery, Chonbuk National University Medical School/Hospital, Jeonju, Korea. dmsqufns@paran.com

Abstract


OBJECTIVE
This study was designed to analyze seizure outcome and to investigate the prognostic factors for predicting seizure outcome according to the preoperative evaluations, surgical procedures, topectomy sites and histopathological findings in patients with extratemporal lobe epilepsy (ETLE).
METHODS
This study comprised 63 patients with ETLE who underwent surgery. Preoperative evaluations included semiologic analysis, chronic video-EEG monitoring, and neuroimaging studies. Surgical procedures consisted of topectomy in 51 patients, corpus callosotomy in 9, functional hemispherectomy in 2, and vagus nerve stimulation (VNS) in 1. Histopathological findings were reviewed. Postoperative seizure outcomes were assessed by Engel's classification at the average follow up period of 66.8 months. Chi-square test was used for statistics.
RESULTS
Total postoperative seizure outcomes were class I in 51 (80%) patients, class II in 6 (10%), class III in 6 (10%). Patients with structural abnormalities on neuroimaging study showed class I in 49 (88%) patients (p<0.05). Patients with focal and regional ictal EEG onset revealed class I in 47 (90%) patients (p<0.05). Semiologic findings, surgical procedures, topectomy sites and histopathological findings did not show statistical correlation with seizure outcome (p>0.05).
CONCLUSION
A good seizure outcome was obtained in patients with ETLE. The factors for favorable seizure outcome are related to the presence of structural abnormalities on neuroimaging study, and focal and regional ictal EEG onset.

Keyword

Epilepsy; Partial treatment outcome; Seizure; Prognostic factor

MeSH Terms

Classification
Electroencephalography
Epilepsy*
Follow-Up Studies
Hemispherectomy
Humans
Neuroimaging
Psychosurgery
Seizures*
Vagus Nerve Stimulation
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