Early Seizures After Temporal Lobectomy Predict Subsequent Seizure Recurrence

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DR. ZHONG YING (Orcid ID : 0000-0002-8498-1373) Article

45%-50% of patients by 10 years after temporal lobectomy 1, and in 60%-70% after extra- temporal resections 2,3 Traditional explanations of surgical failure revolve around the inability

Antiepileptic Medications after Extratemporal Epilepsy

reported rates after temporal lobectomy (4, 5, 9). Univariate analysis identified older age, epilepsy duration, abnormal postoperative EEG, early postoperative seizures, and dyspla-sias or gliosis as predictors of seizure recurrence. However, only abnormal EEG (odds ratio 3.12, 95% confidence interval

Whenisapostoperativeseizureequivalentto epilepsy recurrence

seizures) and analyzed using multivariate regression anal-ysis. Results: After a first seizure, 50% had a recurrence within 1 month and 77% within a year before the risk slowed down to additional 2 3% increments every two subse-quent years. After a second seizure, 50% had a recurrence within 2 weeks, 78% within 2 months, and 83% within 6 months.

REV ISS WEB EPI 3430 53-6 970. - Wiley Online Library

occurrence of early seizures (neighborhood/acute seizures) soon after surgery. Although previously discounted as portending poor outcome, recent data suggest that they do predict seizure recurrence after temporal lobectomy (Park et al., 2002; Radhakrishnan et al., 2003; McIntosh et al., 2005; Tezer et al., 2008; Buckingham et al., 2010), and

Intraoperative electrocorticography in epilepsy surgery

(area where the seizure originates) which is the gold standard for localising the epileptogenic zone3,13. The outcome of epilepsy surgery becomes evident only after serial follow up. The EEG could be an early predictor of the long-term result of surgery15. The surgical failure and postoperative persistence of

Current trends in electroencephalography

interictal discharges may also predict efficacy of anterior temporal lobectomy, in that congruency between temporal spike location and ictal onset was associated with excellent postoperative seizure control. A con-gruent MRI abnormality enhanced further the prob-ability of an excellent surgical outcome to almost 95%.