Temporal Neocorticectomy in Management of Intractable Epilepsy: Long‐Term Outcome and Predictive Factors

Keogan, M.; McMackin, D.; Peng, Syu‐Jyun; Phillips, Jack; Burke, Teresa; Murphy, Sinéad; Farrell, Michael; Staunton, Hugh

doi:10.1111/j.1528-1157.1992.tb02193.x

Cited by 48 publications

(23 citation statements)

References 19 publications

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“…An active program of epilepsy surgery has been established in Dublin since the early 1980s (5,6). This study considering the patients' aims for surgery started in 1994 when a psychiatrist was recruited to the program.…”

Section: Methodsmentioning

confidence: 99%

Patients' Aims for Epilepsy Surgery: Desires Beyond Seizure Freedom

et al. 2001

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Summary:Purpose: To evaluate prospectively patient's aims for epilepsy surgery as previously outlined theoretically by Taylor et al. (Epilepsia 1997;3:625-30).Methods: Ninety-three consecutive patients were interviewed by a psychiatrist as part of their evaluation for epilepsy surgery. Open-ended questions about the patient were asked, and carers' aims or ambitions for change as a result of putative relief of seizures were elicited. The interviewer aimed to obtain a maximum of five aims for later follow-up purposes. These questions were part of an extensive psychiatric interview that is described.Results: The aims of 69 patients or carers were analyzed. The 204 statements of aims were grouped into 59 categories initially. The five most frequently cited constituted 50% of all the aims listed. These aims were desire for work, driving of motor vehicles, independence, socializing, and freedom from drugs. The patients rarely identified a desire for improvement in cognitive functioning as an aim for epilepsy surgery. A final analysis into six categories showed that changes in social process predominated, even over changes in personal behavior. Conclusions:The social and personal aims to accompany relief of epilepsy identified by patients are consistent with the literature on psychosocial adjustment to epilepsy.

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Section: Methodsmentioning

confidence: 99%

Patients' Aims for Epilepsy Surgery: Desires Beyond Seizure Freedom

et al. 2001

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“…One study considered students and persons in a sheltered workshop as being employed (10). Others relied on measures undefined (14,15) or subjective (11,(16)(17)(18) measures (e.g., work "ability," "capacity," "performance," or "career outcome.") Heretofore, only five studies (10,14,16,17,19) statistically analyzed their data, and only one (19) demonstrated significant improvement in unemployment rates.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Work Outcome After Anterior Temporal Lobectomy for Intractable Epilepsy

Reeves

Evans

et al. 1997

Epilepsia

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Summary:Purpose: Whereas the effect of anterior temporal lobectomy on seizure frequency is well recognized, less is known about its impact on work status.Methods: One hundred thirty-four of 190 consecutive patients with temporal lobectomy participated in this study. Eligibility criteria were developed to ensure that only patients with the potential of achieving specific outcomes were included in the corresponding analyses.Results: After surgery, significantly more patients were independent in activities of daily living (p < 0.001) or able to drive (p < 0.001). Income from work also increased (p < 0.01).Nearly one fifth of the patients who were eligible for analysis had either a gain (8%) or a loss (1 1%) of full-or of part-time work. Univariate analyses revealed the following factors to be associated with full-time work after surgery: student or fulltime work within a year before surgery, full-time work experience before surgery, full-or part-time employment experience before surgery, no disability benefits before surgery, low postsurgical seizure frequency, improved postsurgical seizure control, excellent postsurgical seizure control, driving after sur- Conclusions: Anterior temporal lobectomy for intractable epilepsy improves activities of daily living and the ability to drive. Work outcome of this surgery is influenced by presurgical work experience, successful postsurgical seizure control especially to allow driving, and obtaining further education after surgery.

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“…Im Vergleich von Histologie und invasivem EEG mit Tiefenelektroden korreliert das Ausmaß von Zellverlust im CA1-Sektor des Hippokampus mit den iktalen Entladungen [17,27], während interiktale ETP im CA3-Sektor des Hippokampus entstehen [13,17].…”

Section: Diskussionunclassified

“…Grundsätzlich ist die Frage über die zu resezierenden anatomischen Strukturen bei TLE und über die Ausdehnung der Resektion seit langem kontrovers. Einige Zentren führen eine selektive Amygdalohippokampektomie durch [34], andere routinemäßig eine so genannte En-bloc-Standardresektion inklusive anteriorem und lateralem Temporallappen [6,25] oder nur eine Resektion des temporalen Neokortex mit Belassen der mesialen temporalen Strukturen [13]. In zwei Studien gab es signifikant bessere postoperative Ergebnisse mit ausgedehnter Resektion des mesialen Temporallappens [18,32], jedoch keine Korrelation mit der lateralen Ausdehnung der Resektion [18].…”

Section: Introductionunclassified