Document Detail


Prognostic importance of risk factors for temporal lobe epilepsy in patients undergoing surgical treatment.
MedLine Citation:
PMID:  23541008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the prognostic importance of an identified putative underlying risk factor in patients undergoing surgery for intractable temporal lobe epilepsy (TLE).
PATIENTS AND METHODS: A retrospective study of 400 consecutive patients who underwent TLE surgery between December 21, 1987, and September 11, 1996, was performed. Demographic characteristics, history of remote symptomatic neurologic disease, preoperative evaluation, and postoperative outcome data were extracted. Individuals without any risk factors were considered controls. Magnetic resonance imaging findings were used to identify mesial temporal sclerosis (MTS) before surgery. Seizure outcome was classified by a modified Engel classification.
RESULTS: Two hundred eighty-one patients had a potential underlying etiology, and 143 patients had more than 1 risk factor. One hundred nineteen patients had no evidence of a putative symptomatic neurologic illness. There was a statistically significant association (P<.05) between the presence of MTS and a favorable operative outcome (odds ratio, 4.28; 95% CI, 2.67-6.87). A history of remote symptomatic neurologic disease was not of prognostic importance unless associated with the development of MTS.
CONCLUSION: These results indicate that the preoperative identification of MTS by neuroimaging is the most important predictor of a favorable operative outcome in patients with TLE. These findings may be useful in the identification and counseling of potential candidates for epilepsy surgery.
Authors:
Mithri R Junna; Robbie Buechler; Aaron A Cohen-Gadol; Jayawant Mandrekar; Teresa Christianson; W Richard Marsh; Fredric B Meyer; Frederic B Meyer; Gregory D Cascino
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  88     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  2013-07-01     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  England    
Other Details:
Languages:  eng     Pagination:  332-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anterior Temporal Lobectomy*
Child
Epilepsy, Temporal Lobe / etiology,  pathology,  surgery*
Female
Follow-Up Studies
Humans
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Preoperative Period
Retrospective Studies
Risk Factors
Sclerosis
Treatment Outcome
Young Adult
Comments/Corrections
Erratum In:
Mayo Clin Proc. 2013 May;88(5):532
Note: Meyer, Frederic B [corrected to Meyer, Fredric B]

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


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