Posterior cortex epilepsy surgery in childhood and adolescence: predictors of long-term seizure outcome
Objective We aimed to investigate the long-term seizure outcome of children and adolescents who were undergoing epilepsy surgery in the parietooccipital cortex and determine their predictive factors. Methods We retrospectively analyzed the data of 50 consecutive patients aged 11.1 (mean) ± 5.1 (stan...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 18, 2017
|
| In: |
Epilepsia
Year: 2017, Volume: 58, Issue: 3, Pages: 412-419 |
| ISSN: | 1528-1167 |
| DOI: | 10.1111/epi.13654 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1111/epi.13654 Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.13654 
|
| Author Notes: | Georgia Ramantani, Angeliki Stathi, Armin Brandt, Karl Strobl, Susanne Schubert‐Bast, Gert Wiegand, Rudolf Korinthenberg, Vera van Velthoven, Josef Zentner, Andreas Schulze‐Bonhage, and Thomas Bast |
| Summary: | Objective We aimed to investigate the long-term seizure outcome of children and adolescents who were undergoing epilepsy surgery in the parietooccipital cortex and determine their predictive factors. Methods We retrospectively analyzed the data of 50 consecutive patients aged 11.1 (mean) ± 5.1 (standard deviation) years at surgery. All patients but one had a magnetic resonance imaging (MRI)-visible lesion. Resections were parietal in 40%, occipital in 32%, and parietooccipital in 28% cases; 24% patients additionally underwent a resection of the posterior border of the temporal lobe. Etiology included focal cortical dysplasia in 44%, benign tumors (dysembryoplastic neuroepithelial tumor, ganglioglioma, angiocentric glioma, and pilocystic astrocytoma) in 32%, peri- or postnatal ischemic lesions in 16%, and tuberous sclerosis in 8% cases. Results At last follow-up (mean 8 years, range 1.5-18 years), 60% patients remained seizure-free (Engel class I): 30% had discontinued and 20% had reduced antiepileptic drugs. Most seizure recurrences (71%) occurred within the first 6 months, and only three patients presented with seizures ≥2 years after surgery. Independent predictors of seizure recurrence included left-sided as well as parietal epileptogenic zones and resections. Longer epilepsy duration to surgery was identified as the only modifiable independent predictor of seizure recurrence. Significance Our study demonstrates that posterior cortex epilepsy surgery is highly effective in terms of lasting seizure control and antiepileptic drug cessation in selected pediatric candidates. Most importantly, our data supports the early consideration of surgical intervention in children and adolescents with refractory posterior cortex epilepsy. |
|---|---|
| Item Description: | Gesehen am 17.10.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1528-1167 |
| DOI: | 10.1111/epi.13654 |