PURPOSE: To examine long-term seizure and quality-of-life outcome in a homogeneous group of patients after temporal lobectomy with pathologically proven hippocampal sclerosis (HS). Previous research has had limited follow-up (generally <2 years) and has grouped patients across multiple pathologies. METHODS: Fifty consecutive patients were identified as having had a temporal lobectomy for the treatment of temporal lobe epilepsy at Royal Melbourne Hospital with pathologically proven HS and >or=2 years' follow-up. All patients were sent a postal survey concerning seizure activity, quality of life (QOLIE-89), and antiepileptic drug (AED) use. The mean follow-up was 5.8 years (range, 2-9.2). RESULTS: The rate of complete postoperative seizure freedom was 82% at 12 months, 76% at 24 months, and 64% at 63 months (no further seizure recurrences observed after this time). A class I seizure outcome was achieved by 83.3% of patients. Patients with better seizure outcome had significantly better quality of life (Kendall's tau =-234, p < 0.01). Seizure recurrence was associated with a reduction in AED intake or absorption in five (29%) of 17 cases, including three of the five patients with a first seizure recurrence after 24 months after surgery. CONCLUSIONS: Temporal lobectomy provides continued long-term seizure control in the majority of patients with HS. However, patients remain at risk of seizure recurrence >or=2 years after surgery. Long-term quality of life is dependent on seizure outcome.
PURPOSE: To examine long-term seizure and quality-of-life outcome in a homogeneous group of patients after temporal lobectomy with pathologically proven hippocampal sclerosis (HS). Previous research has had limited follow-up (generally <2 years) and has grouped patients across multiple pathologies. METHODS: Fifty consecutive patients were identified as having had a temporal lobectomy for the treatment of temporal lobe epilepsy at Royal Melbourne Hospital with pathologically proven HS and >or=2 years' follow-up. All patients were sent a postal survey concerning seizure activity, quality of life (QOLIE-89), and antiepileptic drug (AED) use. The mean follow-up was 5.8 years (range, 2-9.2). RESULTS: The rate of complete postoperative seizure freedom was 82% at 12 months, 76% at 24 months, and 64% at 63 months (no further seizure recurrences observed after this time). A class I seizure outcome was achieved by 83.3% of patients. Patients with better seizure outcome had significantly better quality of life (Kendall's tau =-234, p < 0.01). Seizure recurrence was associated with a reduction in AED intake or absorption in five (29%) of 17 cases, including three of the five patients with a first seizure recurrence after 24 months after surgery. CONCLUSIONS: Temporal lobectomy provides continued long-term seizure control in the majority of patients with HS. However, patients remain at risk of seizure recurrence >or=2 years after surgery. Long-term quality of life is dependent on seizure outcome.
Authors: Krzysztof A Bujarski; Fuyuki Hirashima; David W Roberts; Barbara C Jobst; Karen L Gilbert; Robert M Roth; Laura A Flashman; Brenna C McDonald; Andrew J Saykin; Rod C Scott; Eric Dinnerstein; Julie Preston; Peter D Williamson; Vijay M Thadani Journal: J Neurosurg Date: 2013-04-26 Impact factor: 5.115
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Authors: P P Quarato; G Di Gennaro; A Mascia; L G Grammaldo; G N Meldolesi; A Picardi; T Giampà; C Falco; F Sebastiano; P Onorati; M Manfredi; G Cantore; V Esposito Journal: J Neurol Neurosurg Psychiatry Date: 2005-06 Impact factor: 10.154
Authors: M E Ahmadi; D J Hagler; C R McDonald; E S Tecoma; V J Iragui; A M Dale; E Halgren Journal: AJNR Am J Neuroradiol Date: 2009-06-09 Impact factor: 3.825