Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

A. Santos
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Abstract

Introduction: Drug-resistant extratemporal epilepsy is the second cause of referral to epilepsy surgery. Objectives: To identify factors associated with short-term seizure recurrence following extratemporal epilepsy surgery. Materials and Methods: We performed a retrospective study of 19 consecutive patients who underwent surgery for drug-resistant extratemporal epilepsy at the National Institute of Neurology and Neurosurgery of Havana, Cuba, from September 2014 to October 2019. All patients had at least one year of postoperative follow-up. Fisher's exact test was used to search for an association between dichotomous variables. A value of p≤0.05 was considered significant. Results: After one year of follow-up, seizure freedom reached 31.6% (Engel I) and 36.8% showed significant improvement in the number of seizures (Engel II). The frontal location (p=0.046) and incomplete resection of the epileptogenic zone (p=0.017), bilateral interictal discharges on the preoperative electroencephalogram (EEG) (p=0.017), the presence of epileptiform discharges on the postsurgical EEG (p=0.001), and the occurrence of seizures after the sixth month of surgery (p=0.001), were associated with seizures recurrence. Conclusions: After one year, 31.6% of patients operated on for extratemporal epilepsy were seizure-free. The incomplete resection of the epileptogenic zone and the presence of epileptogenic discharges in the postsurgical EEG, and the presence of seizures after the sixth month of surgery were the most significant factors of seizure recurrence.
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颞外癫痫手术中短期发作复发的相关因素
简介:耐药颞外癫痫是癫痫手术转诊的第二大原因。目的:探讨颞外癫痫手术后短期癫痫复发的相关因素。材料与方法:我们对2014年9月至2019年10月在古巴哈瓦那国家神经病学和神经外科研究所连续接受耐药颞外癫痫手术的19例患者进行了回顾性研究。所有患者术后随访至少1年。费雪精确检验用于寻找二分类变量之间的关联。p≤0.05被认为是显著的。结果:随访1年后,癫痫发作自由达到31.6% (Engel I),癫痫发作次数明显改善36.8% (Engel II)。额叶位置(p=0.046)和癫痫区切除不全(p=0.017)、术前脑电图双侧间期放电(p=0.017)、术后脑电图癫痫样放电(p=0.001)、术后6个月癫痫发作发生情况(p=0.001)。与癫痫复发有关。结论:手术1年后,31.6%的颞外癫痫患者无癫痫发作。致痫区切除不全、术后脑电图中存在致痫性放电、术后6个月出现癫痫发作是癫痫复发的最重要因素。
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