Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood.
Epilepsy Behav Rep
; 19: 100561, 2022.
Article
em En
| MEDLINE
| ID: mdl-35899185
There is a paucity of data on longitudinal seizure outcome of children undergoing epilepsy surgery. All children (n = 132) who underwent resective epilepsy surgery from January 1998 to December 2015 were identified. Relevant clinical, neurophysiological, imaging, surgical and seizure outcome data were extracted. Multivariable logistic regression analysis and Kaplan-Meier survival with Cox proportional hazard modelling were performed. The mean age at surgery was 7.8 years (range 0.2-17.9). 71% were seizure-free at a mean follow up of 5.3 ± 2.7 years. Of those who were seizure-free, 65 patients were able to completely wean off anti- seizure medications successfully. Using survival analysis, the probability of Engel Class I outcome at one year after surgery was 81% (95% confidence interval [CI] 87%-75%). This dropped to 73% at two years (95% CI 81%-65%), 58% at five years (95% CI 67.8%-48%), and 47% at ten years. Proportional hazard modelling showed that the presence of moderate to severe developmental disability (HR 6.5; p = 0.02) and lack of complete resection (HR 0.4; p = 0.02) maintain association as negative predictors of seizure-free outcome. Our study demonstrates favorable long-term seizure control following pediatric epilepsy surgery and highlights important predictors of seizure outcome guiding case selection and counseling of expectations prior to surgery.
ASM, Anti seizure medication; DEE, Developmental epileptic encephalopathy; ECoG, Electrocorticography; EEG, Electro encephalogram; Epilepsy; Epilepsy surgery; FCD, Focal cortical dysplasia; FDG-PET, Fluorodeoxyglucose positron emission tomography; Focal cortical dysplasia; MRI, Magnetic Resonance Imaging; SPECT, Single-photon emission computed tomography; Tumours
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Epilepsy Behav Rep
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália