Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors.

Abstract:

:OBJECTIVE Epilepsy surgery is an effective means of treating focal epilepsy associated with long-term epilepsy-associated tumors. This study evaluated a large population of surgically treated patients with childhood onset of epilepsy and a histologically confirmed diagnosis of long-term epilepsy-associated tumors. The authors analyzed long-term seizure outcomes to establish whether the time of surgery and patients' ages were determinant factors. METHODS The authors separately investigated several presurgical, surgical, and postsurgical variables in patients operated on before (pediatric group) and at or after (adult group) the age of 18 years. Patients with < 24 months of postsurgical follow-up were excluded from the analysis. RESULTS The patients who underwent surgery before 18 years of age showed better seizure outcomes than those after 18 years of age (80% vs 53.3% Engel Class Ia outcome, respectively; p < 0.001). Multivariate analysis showed that the only variables significantly associated with seizure freedom were complete resection of the lesion, a shorter duration of epilepsy, and temporal lobe resection. CONCLUSIONS The findings of this study indicate that pediatric patients are more responsive to epilepsy surgery and that a shorter duration of epilepsy, complete resection, and a temporal lobe localization are determinant factors for a positive seizure outcome.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Pelliccia V,Deleo F,Gozzo F,Sartori I,Mai R,Cossu M,Tassi L

doi

10.3171/2016.9.JNS161176

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1147-1152

issue

5

eissn

0022-3085

issn

1933-0693

journal_volume

127

pub_type

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