Complications of Epilepsy Surgery: A Single Surgeon's Experience from South India

Panigrahi, Manas; Vooturi, Sudhindra; Jayalakshmi, Sita

doi:10.1016/j.wneu.2016.03.068

Cited by 11 publications

(13 citation statements)

References 31 publications

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“…An increased risk of major neurological complications has been described after surgery within or around eloquent areas 22. A recent series described 18 out of 66 patients (34%) who developed a new sensorimotor deficit after surgery for seizures arising from the rolandic/perirolandic region,24 with similar or even worst results having been reported by previous studies 25–28.…”

Section: Discussionmentioning

confidence: 53%

Surgery in patients with childhood-onset epilepsy: analysis of complications and predictive risk factors for a severely complicated course

d’Orio

Rizzi

Mariani

et al. 2018

J Neurol Neurosurg Psychiatry

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Surgery for childhood-onset focal epilepsy provides excellent results on seizures and an acceptable safety profile at any age. Nevertheless, our results suggest that increasing age at surgery is associated with an increase in odds of developing severe surgery-related complications. These findings support the recommendation that children with drug-resistant symptomatic (or presumed symptomatic) focal epilepsy should be referred for a surgical evaluation as early as possible after seizure onset.

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Section: Discussionmentioning

confidence: 53%

Surgery in patients with childhood-onset epilepsy: analysis of complications and predictive risk factors for a severely complicated course

d’Orio

Rizzi

Mariani

et al. 2018

J Neurol Neurosurg Psychiatry

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“…A total number of 18 studies from 14 countries, which had the inclusion criteria, were reviewed. Of these 18 studies, three studies were from the USA [25][26][27], three were from Turkey [28][29][30], two studies were from Sweden [31,32] and Germany [27,[32][33][34][35][36][37][38][39][40]; Thailand [41], Mexico [42], UK [43], Korea [34], Italy [35], Belgium [36], France [37], India [38], and Canada [39] each had one study included. The common sampling technique was convenience sampling (n = 18).…”

Section: Resultsmentioning

confidence: 99%

“…6a, b). The frequency of epilepsy surgery complications was the most in Belgium (49%) based on one conducted study [36], followed by Italy (30%) based on one study [35], Germany (23.7%) based on two studies [33,40], Thailand (23.1%) based on one study [41], Korea (18.8%) based on one study [34], France (15.4%) based on one study [37], Turkey (14.7%) based on three studies [28][29][30], Mexico (12.7%) based on one study [42], UK (11.9%) based on one study [43], Sweden (8.2%) based on two studies [31,32], USA (5.5%) based on one study, Canada (2.9%) based on one study [39], and India (2%) based on one study [38], respectively (Fig. 7).…”

Section: Resultsmentioning

confidence: 99%

“…Also, the prevalence of surgical complications in the present study was 4.1% (95% CI 3.2-5%, I 2 = 88%). The mortality rate of epilepsy surgery was reported to be 0% in most of the studies [25, 27-32, 36, 37, 39-43]; only studies conducted by Bjellvi and colleagues, Heller and colleagues, and Panigrahi and colleagues reported mortality rates of 0.5%, 0.52%, and 0.14% respectively [26,32,38]. However, Hader and colleagues indicated a 0.4% rate of mortality in temporal lobe patients [58] which is quite consistent with the results of this study.…”

Section: Discussionmentioning

confidence: 99%

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Epilepsy surgery for refractory seizures: a systematic review and meta-analysis in different complications

Mashhad

Harati

Parooie

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Nearly one-third of epilepsy patients are refractory/resistant to medical treatment. Developments made in surgical techniques have significantly increased the effectiveness and safety of these techniques, as such techniques have been demonstrated to improve seizure control/freedom outcomes. Objectives: The aim of this systematic review and meta-analysis was to evaluate the complications of epilepsy surgery. Patient and methods: The searches were conducted by three independent researchers to find the relevant studies published from January 1, 2009, until the end of January 6, 2019. For English published statistical studies, all studies conducted on epileptic patients who have undergone epilepsy surgery were included. Statistical analysis: A meta-analysis was conducted in the STATA14 statistical software. Results: A total of 6735 patients with epilepsy who had undergone the epilepsy surgery were studied. The overall prevalence of complications was 5%. The prevalence of major and minor complications was 5.4% and 3.2% respectively. The prevalence of complications related to the temporal epilepsy surgery and the extra-temporal epilepsy surgery based on 3 studies was 7.9% and 8.2 % respectively. The frequency of neurological and surgical complications after epilepsy surgery was 4.4% and 4.1% respectively. Conclusion: The overall rate of complications caused by epilepsy surgery was reasonably low (5%), implying that epilepsy surgery especially temporal lobe resection can be safe preferably when performed by an experienced surgeon.

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“…These included 1 case of monoparesis and dystonia, 2 of hemiparesis, and 1 of memory dysfunction that was not transient. 43 hemiplegia, and 3 cases in which the patient required repeat surgery for refractory seizures in their cohort of 164 patients undergoing ATL ± AH; only 29 of 164 patients undergoing surgery were followed to the 3-year mark. 50 Among the 118 patients with at least 1-year follow-up reported by Dagar et al, 14 (11.8%) experienced either medical or postsurgical complications; there were no deaths.…”

Section: Adverse Events Associated With Atl ± Ahmentioning

confidence: 99%

Surgical outcomes for medically intractable epilepsy in low- and middle-income countries: a systematic review and meta-analysis

Mansouri

Taslimi²,

Abbasian

et al. 2019

Journal of Neurosurgery

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OBJECTIVEThe aim of this study was to describe the current state of epilepsy surgery and establish estimates of seizure outcomes following surgery for medically intractable epilepsy (MIE) in low- and middle-income countries (LMICs).METHODSThe MEDLINE and Embase databases were searched without publication date restriction. This search was supplemented by a manual screen of key epilepsy and neurosurgical journals (January 2005 to December 2016). Studies that reported outcomes for at least 10 patients of any age undergoing surgery for MIE in LMICs over a defined follow-up period were included. A meta-analysis with a random-effects model was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. Pooled estimates of seizure freedom and favorable seizure outcomes following anterior temporal lobectomy with or without amygdalohippocampectomy (ATL ± AH) were reported.RESULTSTwenty studies were selected, of which 16 were from Asian centers. The average age at surgery in all studies was less than 30 years, and the average preoperative duration of epilepsy ranged from 3 to 16.1 years. Mesial temporal sclerosis accounted for 437 of 951 described pathologies, and 1294 of the 1773 procedures were ATL ± AH. Based on 7 studies (646 patients) the pooled seizure freedom estimate following ATL ± AH was 68% (95% CI 55%–82%). Based on 8 studies (1096 patients), the pooled estimate for favorable seizure outcomes was 79% (95% CI 74%–85%).CONCLUSIONSSurgery for MIE in LMICs shows a high percentage of seizure freedom and favorable outcomes. These findings call for a concerted global effort to improve timely access to surgery for MIE patients in these regions, including investments aimed at refining existing and establishing additional centers.

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Complications of Epilepsy Surgery: A Single Surgeon's Experience from South India

Cited by 11 publications

References 31 publications

Surgery in patients with childhood-onset epilepsy: analysis of complications and predictive risk factors for a severely complicated course

Surgery in patients with childhood-onset epilepsy: analysis of complications and predictive risk factors for a severely complicated course

Epilepsy surgery for refractory seizures: a systematic review and meta-analysis in different complications

Surgical outcomes for medically intractable epilepsy in low- and middle-income countries: a systematic review and meta-analysis

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