Document Detail


Epilepsy surgery in Argentina: long-term results in a comprehensive epilepsy centre.
MedLine Citation:
PMID:  21478034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Epilepsy surgery procedures started in Argentina more than 50 years ago. This is the first comprehensive and systematic survey of epilepsy surgery long-term outcome from our country.
METHODS: A descriptive cohort study was conducted between 1998 and 2008 for drug-resistant epilepsy surgery with a minimum of 12 months follow-up (n=110). In 84 cases (76.36%) resective surgery was performed, and outcome periodically assessed using the Engel score. Patients were stratified into groups: 12, 13-36, 37-60 and over than 60 months of follow-up. Video-EEG with and without intracranial electrode implants, intraoperative electrocorticograms, Wada tests, pathology reports, use of antiepileptic drugs (AEDs), and surgical complication rates were evaluated.
RESULTS: Surgical techniques included: 69 lobectomies (62.7%), 15 lesionectomies (13.6%), 6 callosotomies (5.4%), 6 multiple subpial transection (5.4%), 11 vagus nerve stimulations (10%), 3 hemispherectomies (2.7%). Male: female ratio: 1/1.44. Mean age at time of surgery: 26.2 years. Mean duration of epilepsy: 14 years. Age at seizure onset: 11.5 years. Mean follow-up: 46 months. Pathology findings: mesial temporal sclerosis 32 (35.1%); dual pathology 17 (18.7%); cortical dysplasia 15 (16.4%); non-specific inflammatory changes 11 (12.1%); tumors 7 (7.7%); other 6 (6.8%). Engel scores at 12 months follow-up: 72.6% (61) class I, 16.6% (14) class II and 15.5% (13) class III-IV; 13-36 months after surgery: 68.1% of cases were class I, 15.9% class II and 15.5% class III-IV. After 37-60 months, 74% class I, 14% class II, 14% class III-IV. Over 60 months (n=45) 78% class I, 13.5% class II and 8.1% class III-IV.
CONCLUSION: Conducting a successful epilepsy surgery program in a developing country is challenging. These results should encourage specialists in these countries. Long-term outcome results comparable to centres in developed countries can be achieved.
Authors:
Martín Donadío; Carlos D'Giano; Mauricio Moussalli; Leonardo Barrios; Gabriela Ugarnes; Mónica Segalovich; Juan Pociecha; Claudio Vázquez; Cesar Petre; Hugo Pomata
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Publication Detail:
Type:  Journal Article     Date:  2011-04-07
Journal Detail:
Title:  Seizure     Volume:  20     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-13     Completed Date:  2011-10-06     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  442-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / therapeutic use
Argentina
Child
Child, Preschool
Cohort Studies
Databases, Factual
Disability Evaluation
Drug Resistance
Electroencephalography
Epilepsy / mortality,  surgery*
Female
Follow-Up Studies
Humans
Infant
Male
Middle Aged
Neurosurgery / trends*
Neurosurgical Procedures / adverse effects,  statistics & numerical data,  trends*
Retrospective Studies
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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