Quality of life following epilepsy surgery for children with tuberous sclerosis complex

Roth, Jonathan; Olasunkanmi, Adeolu; MacAllister, William S.; Weil, Emily; Uy, Catherine C.; Devinsky, Orrin; Weiner, Howard L.

doi:10.1016/j.yebeh.2010.11.003

Cited by 36 publications

(37 citation statements)

References 25 publications

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“…Despite a prolonged hospital course with a least 2 operations, 37 of 39 families were extremely satisfied and would have undergone the entire procedure again if they had known all that actually happened, including complications and length of stay. 7 In a previous study of staged epilepsy surgery by our group, two thirds had a new neurological deficit; however, 80% were transient. In that series, we stated 20% non-CNS-related infections, 15% noninfectious fevers, and 15% hydrocephalus.…”

Section: Key Resultsmentioning

confidence: 69%

“…Our seizure and quality of life outcomes in children with TSC-related epilepsy, for example, have shown that 70% of children have at least a 90% reduction of seizures, coupled with improved patient and family quality of life. 6,7 We use similar surgical techniques for other challenging cases besides TSC, including malformations of cortical development. The decision to proceed with a staged approach rather than a simple single-stage resection for a specific patient is made collectively at our CEC conference with epileptologists and neurosurgeons.…”

Section: Key Resultsmentioning

confidence: 99%

“…This approach has resulted in improvements in both the patient's and the family's quality of life and, not infrequently, seizure freedom with a low complication rate. 7 Despite our previous publications describing the efficacy of staged epilepsy surgery on the epileptic disease, including in refractory multifocal epilepsy (such as TSC), this approach is not widely practiced. 6 The reasons for reluctance to apply such a surgical strategy may be related to concerns over potential complications that may arise from multiple surgical procedures.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Safety of Staged Epilepsy Surgery in Children

Roth¹,

Carlson²,

Devinsky³

et al. 2014

Neurosurgery

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Section: Key Resultsmentioning

confidence: 69%

Section: Key Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Safety of Staged Epilepsy Surgery in Children

Roth¹,

Carlson²,

Devinsky³

et al. 2014

Neurosurgery

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“…There are various approaches to seizure control, including drug therapy and surgery for those patients with epileptogenic tubers. 13,[15][16][17][18][19] Despite the antiepileptic drug therapy options available, the lack of seizure control remains an area of unmet need in this population.…”

mentioning

confidence: 99%

Resource Utilization in Children With Tuberous Sclerosis Complex and Associated Seizures

Lennert¹,

Farrelly²,

Sacco

et al. 2012

J Child Neurol

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Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

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“…Surgical treatment has been shown to result in a significant control of epilepsy and improvements in the quality of life of children with TS [6]. These surgical strategies have, however, changed dramatically over the last several decades.…”

Section: Introductionmentioning

confidence: 99%

Changing Global Trends in Seizure Outcomes Following Resective Surgery for Tuberous Sclerosis in Children with Medically Intractable Epilepsy

Ibrahim

Fallah

Snead

et al. 2012

Epilepsy Research and Treatment

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Introduction. Tuberous sclerosis (TS) is the leading cause of genetic epilepsy worldwide. Here, we evaluate changes in seizure outcomes following resective epilepsy surgery in children with TS over time. Methods. A systematic review of the literature was performed to identify studies reporting seizure outcomes following resective epilepsy surgery in children with TS. Using an individual participant meta-analysis approach, seizure outcomes and associated covariates were combined. Multivariate logistic regression was used to determine significant associations between seizure outcomes and time of surgery. Results. Twenty studies from 1966 to present, yielding 186 participants, met the inclusion criteria for the study. On univariate analysis, there was a significant improvement in seizure outcomes in children who underwent resective epilepsy surgery within the last 15 years compared to older cohorts (chi-square 4.1; P = 0.043). On multivariate analysis, adjusting for length of followup, this trend was not significant (OR 0.52; 95% CI 0.23–1.17; P = 0.11). In the last 15 years, a greater proportion of younger children also underwent resective surgery compared to older cohorts (OR 0.93; 95% CI 0.89–0.97; P < 0.01). Conclusions. A trend towards improved seizure outcomes following resective surgery for TS was observed from 1966 to present on multivariate analysis.

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Quality of life following epilepsy surgery for children with tuberous sclerosis complex

Cited by 36 publications

References 25 publications

Safety of Staged Epilepsy Surgery in Children

Safety of Staged Epilepsy Surgery in Children

Resource Utilization in Children With Tuberous Sclerosis Complex and Associated Seizures

Changing Global Trends in Seizure Outcomes Following Resective Surgery for Tuberous Sclerosis in Children with Medically Intractable Epilepsy

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