Xinghui He1,2, Yuguang Guan1,2, Feng Zhai1,2, Jian Zhou1,2, Tianfu Li1,3, Guoming Luan1,2,3. 1. 1Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University. 2. 2Department of Neurosurgery, Epilepsy Center, Sanbo Brain Hospital, Capital Medical University; and. 3. 3Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
Abstract
OBJECTIVE: The object of this study was to evaluate surgical outcomes and prognosis factors in patients with drug-resistant posttraumatic epilepsy (PTE) who had undergone resective surgery. METHODS: The authors retrospectively reviewed the records of all patients with drug-resistant PTE who had undergone resective surgery at Sanbo Brain Hospital, Capital Medical University, in the period from January 2008 to December 2016. All patients had a follow-up period of at least 2 years. Seizure outcomes were evaluated according to the International League Against Epilepsy (ILAE) classification. Patients in ILAE classes 1 and 2 during the last 2 years of follow-up were classified as having a favorable outcome; patients in all other classes were considered to have an unfavorable outcome. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. RESULTS: Among 90 patients with a follow-up of 2-10 years (mean ± standard deviation, 5.79 ± 2.84 years), 70% (63 patients) were seizure free, of whom 68.9% (62 patients) had an ILAE class 1 outcome and 1.1% (1 patient) had an ILAE class 2 outcome. Permanent neurological deficits were observed in 10 patients (11.1%). Univariate and multivariate analyses revealed that only the duration of seizures ≤ 8 years was an independent predictor of a favorable seizure outcome (OR 0.34, 95% CI 0.13-0.92). CONCLUSIONS: Resective surgery is an effective treatment for patients with drug-resistant PTE with an acceptable incidence of complications. The information on prognosis factors suggests that early surgery may offer more benefits to patients with drug-resistant PTE.
OBJECTIVE: The object of this study was to evaluate surgical outcomes and prognosis factors in patients with drug-resistant posttraumatic epilepsy (PTE) who had undergone resective surgery. METHODS: The authors retrospectively reviewed the records of all patients with drug-resistant PTE who had undergone resective surgery at Sanbo Brain Hospital, Capital Medical University, in the period from January 2008 to December 2016. All patients had a follow-up period of at least 2 years. Seizure outcomes were evaluated according to the International League Against Epilepsy (ILAE) classification. Patients in ILAE classes 1 and 2 during the last 2 years of follow-up were classified as having a favorable outcome; patients in all other classes were considered to have an unfavorable outcome. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. RESULTS: Among 90 patients with a follow-up of 2-10 years (mean ± standard deviation, 5.79 ± 2.84 years), 70% (63 patients) were seizure free, of whom 68.9% (62 patients) had an ILAE class 1 outcome and 1.1% (1 patient) had an ILAE class 2 outcome. Permanent neurological deficits were observed in 10 patients (11.1%). Univariate and multivariate analyses revealed that only the duration of seizures ≤ 8 years was an independent predictor of a favorable seizure outcome (OR 0.34, 95% CI 0.13-0.92). CONCLUSIONS: Resective surgery is an effective treatment for patients with drug-resistant PTE with an acceptable incidence of complications. The information on prognosis factors suggests that early surgery may offer more benefits to patients with drug-resistant PTE.