Document Detail

Improvement and deterioration of seizure control during the postsurgical course of epilepsy surgery patients.
MedLine Citation:
PMID:  9924903     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine the factors associated with changes in seizure control during the postsurgical course of epilepsy surgery patients. METHODS: Evaluation of patients after consecutive temporal and frontal resection whose seizure frequency was scored for each year of postsurgical follow-up. In each cohort, patients with a change in their seizure control after the first postsurgical year were compared with control subjects to determine factors that may be responsible for the change. RESULTS: Thirty-three (15%) of 214 temporal lobectomy versus 12 (20%) of 59 frontal resection patients experienced a change in seizure control (p>0.05). Ten (5%) of 214 temporal lobectomy versus nine (15%) of 59 frontal resection patients experienced an improvement in seizure control (p = 0.009), but 23 (11%) of 214 temporal lobectomy versus three (5%) of 59 frontal resection patients had a worsening in seizure control (p>0.05). In temporal lobectomy patients, preoperative unilateral temporal epileptiform discharges were associated with improvement (p = 0.03), whereas older age at surgery was associated with worsening of seizure control (p = 0.007). In frontal resection patients, presence of a congenital central nervous system (CNS) anomaly was associated with late improvement in seizure control (p = 0.006). CONCLUSION: During the postsurgical course, an improvement in seizure control is more common after frontal resection than after temporal lobectomy. Factors associated with improvement are the presence of a congenital CNS abnormality in frontal resection patients, and the occurrence of preoperative unilateral epileptiform discharges in temporal lobectomy patients. Older age at temporal lobectomy may be associated with greater risk of worsening seizure control.
D M Ficker; E L So; R K Mosewich; K Radhakrishnan; G D Cascino; F W Sharbrough
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  40     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-04     Completed Date:  1999-02-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  62-7     Citation Subset:  IM    
Division of Epilepsy and Section of Electroencephalography, Mayo Clinic and Mayo Medical School, Rochester, Minnesota, USA.
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MeSH Terms
Age Factors
Electroencephalography / statistics & numerical data
Epilepsy / physiopathology,  surgery*
Epilepsy, Frontal Lobe / physiopathology,  surgery
Epilepsy, Temporal Lobe / physiopathology,  surgery
Follow-Up Studies
Frontal Lobe / physiopathology,  surgery*
Functional Laterality
Postoperative Period
Severity of Illness Index
Temporal Lobe / physiopathology,  surgery*
Treatment Outcome

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

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