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Long-term seizure and social outcomes following temporal lobe surgery for intractable epilepsy during childhood.

Abstract：

PURPOSE:Studies of adults who underwent temporal lobectomy for intractable temporal lobe epilepsy (TLE) demonstrated declining seizure free rates over time. Using seizure and social parameters, we followed patients who had temporal lobe surgery (TLS) in childhood to determine long-term outcomes. METHODS:We identified 42 patients who underwent TLS for medically intractable epilepsy during childhood. Follow-up data were collected from 10 to 20 years after surgery (median, 12 years). We studied histopathology, seizure outcome, employment, school enrolment, and driver's licensing. Patients or parents graded their satisfaction with TLS. RESULTS:Number of Engel class I patients was 34 (81%) after 6 months; 32 (76%) after 1 year; 30 (71%) after 5 years; and 28 (67%) at last >or=10 years follow-up. Nineteen (79%) of 24 children with tumors or cavernous angioma achieved class I outcomes in contrast to 9 (50%) of 18 children with other pathologies (p<0.05). Ten (56%) of 18 recurrent seizure patients experienced seizures within the first year; 4 required reoperation for seizure freedom. More seizure free patients (24, 86%) than residual seizure patients (8, 57%) were employed or in school (p=0.05). Twelve (63%) of 19 eligible patients obtained driver's licenses. Twenty-three (82%) of 28 seizure free patients discontinued anticonvulsants. Surgery grading averaged "satisfied." Class I patients reported greater satisfaction than class III/IV patients (p<0.001). CONCLUSION:Two-thirds of children who underwent TLS achieved seizure freedom at >or=10 year follow-up. Children with tumors or cavernous angiomas achieved better long-term outcomes than those with other histopathologies. Long-term seizure free patients were most often satisfied with surgery and employed or in school.

journal_name

Epilepsy Res

journal_title

Epilepsy research

authors

Benifla M,Rutka JT,Otsubo H,Lamberti-Pasculli M,Elliott I,Sell E,RamachandranNair R,Ochi A,Weiss SK,Snead OC 3rd,Donner EJ

doi

10.1016/j.eplepsyres.2008.07.012

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

133-8

issue

2-3

eissn

0920-1211

issn

1872-6844

pii

S0920-1211(08)00214-3

journal_volume

82

pub_type

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