Postsurgical outcomes in a cohort of patients with hippocampal sclerosis: Initial experience in a referral epilepsy center in Peru

Abstract

Mesial temporal lobe epilepsy, one of the most common forms of epilepsy, is often linked with drug resistance. Surgical intervention is a reliable and safe treatment option, though research into postsurgical outcomes in our locality remains limited. We performed a retrospective observational study included 91 patients with mesial temporal lobe epilepsy and hippocampal sclerosis who had undergone anterior temporal lobectomy between 2012 and 2020 at a surgical epilepsy center located in Lima, Peru. Postoperative outcomes were analyzed using bivariate and multivariate analysis based on the Engel classification. We found that after 12 months of follow‐up, 78.65% of the 91 patients achieved an Engel IA classification, while 9.09% attained Engel IB classification and 11.24% were designated as Engel II, with only 1.12% classified as Engel IVA. The median QOLIE31 score was 84 (IQR: 75–90), with 74.16% of the participants successfully reintegrating into academic or employment activities. After 24 months, only 68 patients completed the follow‐up, with 69.12% achieving an Engel IA classification. Individuals with a secondary education or higher were more likely to achieve an Engel IA classification at 12 months (OR: 5.11; P = 0.005; CI: 1.63–16.01), after adjusting for sex and age. We concluded that most patients exhibited favorable outcomes after 1 year of follow‐up. However, lower educational attainment was linked to worse postsurgical outcomes.

Epilepsy Care in Latin America and the Caribbean: Overcoming Challenges and Embracing Opportunities

“…While the overall number of reported cases is small, seizure control results (measured by Engel classification) are comparable to those of HIC. 48 The first epilepsy surgeries in Latin America were conducted by Rafael Lavista in Mexico in 1892, 49 followed by the first reported surgery in Uruguay in 1898. 50 Comprehensive epilepsy centers in the region first emerged in the last 1990s, with Uruguay, Argentina, Costa Rica, Colombia, Peru, and Paraguay establishing and advancing their epilepsy surgery programs in the subsequent years.…”