Resultados quirúrgicos a largo plazo en pacientes con epilepsia fármaco-resistente del lóbulo temporal sin anormalidades histológicas

Benedetti-Isaac, Juan Carlos; Torres-Zambrano, Martín; Fandiño‐Franky, Jaime; Dussán-Ordóñez, J.; Herrera-Trujillo, A.; Guerra-Olivares, Randy; Alcala-Cerra, Gabriel

doi:10.1016/j.nrl.2013.01.011

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…The result from the AMTL subgroup in this study is similar to the findings of Benedetti-Isaac et al [3] who reported the seizure freedom rate, at mean 6.5-year follow-up, in 42.9% of patients with N-MRI and N-HP who underwent the same surgical procedure. Thus, these promising results are particularly important in the current era when epilepsy surgery is underutilised, especially in TLE subgroup with N-MRI.…”

Section: Discussionsupporting

confidence: 91%

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Seizure outcomes of temporal lobe epilepsy surgery in patients with normal MRI and without specific histopathology

et al. 2017

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BackgroundSeizure outcome following surgery in pharmacoresistant temporal lobe epilepsy patients with normal magnetic resonance imaging and normal or non-specific histopathology is not sufficiently presented in the literature.MethodsIn a retrospective design, we reviewed data of 263 patients who had undergone temporal lobe epilepsy surgery and identified 26 (9.9%) who met the inclusion criteria. Seizure outcomes were determined at 2-year follow-up. Potential predictors of Engel class I (satisfactory outcome) were identified by logistic regression analyses.ResultsEngel class I outcome was achieved in 61.5% of patients, 50% being completely seizure free (Engel class IA outcome). The strongest predictors of satisfactory outcome were typical ictal seizure semiology (p = 0.048) and localised ictal discharges on scalp EEG (p = 0.036).ConclusionSurgery might be an effective treatment choice for the majority of these patients, although outcomes are less favourable than in patients with magnetic resonance imaging-defined lesional temporal lobe epilepsy. Typical ictal seizure semiology and localised ictal discharges on scalp EEG were predictors of Engel class I outcome.

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Section: Discussionsupporting

confidence: 91%

“…It is estimated that 20–30% of TLE patients have no lesion on MRI (N-MRI) [7, 35]. Unlike in patients with HS, the rate of seizure freedom following TLE surgery in this subgroup is lower and varies from 20 to 80% [2, 3, 5, 8, 21, 24, 34, 37]. …”

Section: Introductionmentioning

confidence: 99%

Seizure outcomes of temporal lobe epilepsy surgery in patients with normal MRI and without specific histopathology

et al. 2017

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Prognostic factors for seizure outcome in patients with MRI-negative temporal lobe epilepsy: A meta-analysis and systematic review

Wang

Zhang

Wang

et al. 2016

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Epilepsy surgery in low- and middle-income countries: A scoping review

Watila

Xiao

Keezer

et al. 2019

Epilepsy & Behavior

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Background: Epilepsy surgery is an important treatment option for people with drug resistant epilepsy. Although surgical procedures are under-utilized worldwide, it is far worse in Low-and Middle-Income Countries (LMIC) and it is less clear to what extent people with drug resistant epilepsy receive such treatment at all. Here we review the existing evidence for the availability and outcome of epilepsy surgery in LMIC, and discuss some challenges and priority. Methods: We used the six stage methodological framework developed by Arskey and O'Malley as a guide. We searched PubMed, Embase, Global Health Archives, Index Medicus for South East Asia Region (IMSEAR), Index Medicus for Eastern Mediterranean Region (IMEMR), Latin American & Caribbean Health Sciences Literature (LILACS), African Journal Online (AJOL), and African Index Medicus (AIM) to identify the relevant literature. Results: We retrieved 148 articles on epilepsy surgery from 31 countries representing 22% of the 143 LMIC. Epilepsy surgery appears established in some of these centers in Asia and Latin America, while some are in their embryonic stage reporting procedures in a small cohort performed mostly by motivated neurosurgeons. The commonest surgical procedure reported was temporal lobectomies. The post-operative seizure-free rates and quality of life are comparable to those in the high-income countries (HIC). Some models have shown that epilepsy surgery can be performed within a resourcelimited setting through collaboration with international partners and through the use of information and communication technology. The cost of surgery is a fraction of what is available in HIC. Conclusion: This review has demonstrated the availability of epilepsy surgery in few LMIC. The information available is inadequate to make any reasonable conclusion of its existence as routine practice. Collaborations with international partners can provide an opportunity to bring high-quality academic training and technological transfer directly to surgeons working in these regions and should be encouraged.

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Resultados quirúrgicos a largo plazo en pacientes con epilepsia fármaco-resistente del lóbulo temporal sin anormalidades histológicas

Abstract: Although long-term surgical outcomes were favourable for a large majority of patients, the percentage of seizure-free patients is lower than in patients with lesional epilepsy and comparable to that previously reported in the literature.

Cited by 5 publications

References 40 publications

Seizure outcomes of temporal lobe epilepsy surgery in patients with normal MRI and without specific histopathology

Seizure outcomes of temporal lobe epilepsy surgery in patients with normal MRI and without specific histopathology

Prognostic factors for seizure outcome in patients with MRI-negative temporal lobe epilepsy: A meta-analysis and systematic review

Epilepsy surgery in low- and middle-income countries: A scoping review

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