Your browser doesn't support javascript.
loading
Pediatric Temporal Lobe Epilepsy Surgery in Bonn and Review of the Literature.
Ormond, D Ryan; Clusmann, Hans; Sassen, Robert; Hoppe, Christian; Helmstaedter, Christoph; Schramm, Johannes; Grote, Alexander.
Afiliação
  • Ormond DR; Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.
  • Clusmann H; Department of Neurosurgery, University of Aachen, Aachen, Germany.
  • Sassen R; Department of Epileptology, Bonn University Medical Center, Bonn, Germany.
  • Hoppe C; Department of Neuropsychology, Bonn University Medical Center, Bonn, Germany.
  • Helmstaedter C; Department of Neuropsychology, Bonn University Medical Center, Bonn, Germany.
  • Schramm J; Medical Faculty, Bonn University Medical Center, Bonn, Germany.
  • Grote A; Department of Neurosurgery, Bielefeld Medical Center, Bielefeld, Germany.
Neurosurgery ; 84(4): 844-856, 2019 04 01.
Article em En | MEDLINE | ID: mdl-29668992
BACKGROUND: Epilepsy surgery is well established as safe and successful for children with temporal lobe epilepsy (TLE). Despite evidence from available data, there remains some reluctance to refer children with medically refractory epilepsy for preoperative evaluation and workup for possible surgery. OBJECTIVE: To present the largest case series of pediatric (TLE) patients thus far, in order to better understand the predictability of preoperative evaluation on seizure outcome, and to better understand longitudinal outcomes in a large pediatric cohort. METHODS: One hundred eighty-three pediatric patients with TLE who underwent surgical treatment between 1988 and 2012 were retrospectively reviewed. Preoperative seizure history, noninvasive and invasive preoperative evaluation, surgical results, pathological results, long-term seizure outcomes, and complications were evaluated. A review of pediatric TLE in the literature was also undertaken to better understand reported complications and long-term outcomes. RESULTS: Mean follow-up was 42 mo (range 12-152 mo); 155 patients had good seizure outcomes (Engel I/II; 84.8%) and 28 patients had poor seizure outcomes (Engel III/IV; 15.2%); 145 patients were Engel I (78.8%). Only 10 patients did not have worthwhile improvement (Engel class IV; 5.4%). A review of the literature identified 2089 unique cases of pediatric TLE. Satisfactory seizure outcomes occurred in 1629 patients (79%) with unsatisfactory outcomes in 433 patients (21%). CONCLUSION: Pediatric patients benefit from surgery for medically refractory TLE with an acceptable safety profile regardless of histopathological diagnosis, seizure frequency, or seizure type. Seizure freedom appears to have extensive durability in a significant proportion of surgically treated patients.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Neurocirúrgicos / Epilepsia do Lobo Temporal Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Revista: Neurosurgery Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Neurocirúrgicos / Epilepsia do Lobo Temporal Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Revista: Neurosurgery Ano de publicação: 2019 Tipo de documento: Article