Quantitative Analysis of Seizure Frequency 1 Week and 6, 12, and 24 Months After Surgery of Epilepsy

Lüders, Hans; Murphy, D.; Awad, Issam A.; Wyllie, Elaine; Dinner, Dudley S.; Morris, Harold H.; Rothner, A. David

doi:10.1111/j.1528-1157.1994.tb01785.x

Cited by 46 publications

(43 citation statements)

References 15 publications

(14 reference statements)

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“…Maybe the worse longterm outcome originated from the preoperative long time course of seizures, which is thought to be important in the establishment of independent seizure foci (2). Another reason for the progressive deterioration could be the incomplete resection of the epileptogenic lesion, which led to progressive relapse of seizures (23,33). Nevertheless, the important message of the first study of Baumann et al (5) was the improvement of the seizure outcome after the complete removal of cavernoma-surrounding hemosiderin-stained tissue in patients with pharmacotherapy-refractory epilepsy.…”

Section: Outcome Versus Excision Of Surrounding Gliosismentioning

confidence: 97%

Long-Term Seizure Control After Resection of Supratentorial Cavernomas

et al. 2008

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Section: Outcome Versus Excision Of Surrounding Gliosismentioning

confidence: 97%

Long-Term Seizure Control After Resection of Supratentorial Cavernomas

et al. 2008

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“…16,40,43 Illustrative Case This 3.5-year-old boy with TSC presented with a history of ~ 300 simple partial seizures per month, each described as a characteristic "stare" and clonic movements beginning in the left arm and progressing to the left leg and occasionally the right side. Multiple medications failed to treat the patient's condition.…”

Section: Neurosurg Focus / Volume 25 / September 2008mentioning

confidence: 99%

Epilepsy surgery and tuberous sclerosis complex: special considerations

Bollo¹,

Kalhorn²,

Carlson

et al. 2008

FOC

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Epilepsy surgery for medically refractory seizures among patients with tuberous sclerosis complex (TSC) is a well-accepted treatment option. Many epilepsy centers around the world have published their experience over the past several years, supporting the idea that the best seizure control is obtained when a single tuber and associated epileptogenic zone is documented and targeted surgically. Recent advances in imaging and physiological techniques that reveal the epileptogenic zone have been used successfully in children with TSC who are being evaluated for surgery. As a result, a number of different surgical strategies have emerged, each reflecting the experience, strengths, and referral biases of the individual treating teams. Experience suggests that some patients with TSC who present with seizures that are difficult to localize and do not meet the classic selection criteria for epilepsy surgery may, nevertheless, benefit from sugery. Tuberectomy alone is often not sufficient for obtaining seizure control. Intracranial electrode recordings performed in a large number of children with TSC undergoing epilepsy surgery have raised new questions about the relationship of the cortical tuber to the epileptogenic zone in TSC. A careful assessment of the risks and benefits of any surgical strategy, compared with those associated with continued refractory epilepsy, should be considered by the treating team in conjunction with the patient's family. Epilepsy surgery has not only benefited many children with TSC, but it also facilitates the understanding of epileptogenesis in TSC.

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“…A patient with lateralizing ictal and interictal (i.e., concordant) EEG findings was classified as an optimal surgery candidate, whereas the patient with a nonlateralizing or contralatera1 ictal or interictal finding (i.e., discordant) was classified as a suboptimal candidate. Previous studies have suggested that these two groups may have differing base rates of surgery outcome (1 [8][9][10][11][12][13][14][15][16][17][18][19][20]. We recognize that this distinction is crude, and use it only to illustrate the interaction between base rate and predictive utility.…”

Section: Discussionmentioning

confidence: 99%

“…Auras were not considered seizures for the purpose of the study. A 6-month postoperative assessment of seizure status has been shown to be a good predictor of future seizure status (16). Of the 79 patients with LATL, 59 (74.7%) were seizure-free postopera- …”

Section: Methodsmentioning

confidence: 99%

Contribution of Neuropsychological Data to the Prediction of Temporal Lobe Epilepsy Surgery Outcome

et al. 1998

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Summary: Purpose:We empirically examined the contribution of' neuropsychological data to the prediction of postoperative seizure control relative to base rate information in an existing series of patients undergoing anterior temporal lobectomy (ATL).Methods: A discriminant function predicting surgery outcome (seizure-free vs. non-seizure-free) was computed separately for samples of patients with left (n = 79) and right (n = 62) temporal lobectomy (LATL, RATL). Predictor variables included 14 measures tapping five neurocognitive domains. The predicted base rates were compared with the actual base rates in the two samples. Finally, overall predictive accuracy was examined in optimal versus suboptimal ATL patients.Results: The base rate of seizure freedom in the LATL group was 74.70%; that in the RATL group was 66.10%. The predictive function for the LATL group achieved a hit rate of 80.00% and a positive predictive power of 92.1 1%. The function for the RATL group achieved a hit rate of 83.33% and a positive predictive power (PPP) of 89.66%. The overall predictive accuracy for the optimal group was only 55%, but that in the suboptimal group was 72%.Conclusions: Neuropsychological data used in a multivariate statistical fashion may be able to offer an incremental increase in the prediction of postoperative seizure freedom relative to existing base rates of surgery success in patients with ATL epilepsy. The use of neuropsychological data may be of greatest predictive value in a population of ATL candidates with suboptimal findings with a lower base rate of postoperative seizure freedom, but may actually reduce predictive accuracy in a group of ATL candidates from an optimal population with an already high base rate of surgical success.

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Quantitative Analysis of Seizure Frequency 1 Week and 6, 12, and 24 Months After Surgery of Epilepsy

Cited by 46 publications

References 15 publications

Long-Term Seizure Control After Resection of Supratentorial Cavernomas

Long-Term Seizure Control After Resection of Supratentorial Cavernomas

Epilepsy surgery and tuberous sclerosis complex: special considerations

Contribution of Neuropsychological Data to the Prediction of Temporal Lobe Epilepsy Surgery Outcome

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