Outcome of surgical treatment of hippocampal sclerosis from relatively new epilepsy surgery center
Journal of Neurosurgical Sciences, cilt.60, sa.2, ss.159-168, 2016 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 60 Sayı: 2
- Basım Tarihi: 2016
- Dergi Adı: Journal of Neurosurgical Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.159-168
- Anahtar Kelimeler: Epilepsy, Anterior temporal lobectomy, Outcome assessment, health care
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
BACKGROUND: Surgery is apparently superior to prolonged medical therapy in therapy of eficacy and safety for mesial temporal lobe epilepsies. We - as a new center - presented outcome results and possible outcome predictors of 50 consecutive patients with hippocampal sclerosis underwent resective epilepsy surgery. MeTHoDs: Between 2006 and 2011, ifty patients with intractable mesial temporal lobe epilepsy due to hippocampal sclerosis underwent anterior temporal lobectomy and they were followed-up at least 1 year postoperatively. Detailed neuropsychological tests, video-electroencephalography monitoring and magnetic resonance imaging with epilepsy protocol were obtained for all patients. standard anteromedial temporal lobectomy was performed. Modiied Engel and ILAE classiications were used for seizure outcome. All morbidities were recorded. Demographic variables, diagnostic tests and early postoperative outcome were analyzed for possible predictors of the ultimate seizure outcome. resulTs: Fifty patients were evaluated. The mean follow-up duration was 47,1 month (range, 12-75 months). The favorable outcome at 1 year was 90% and 82% according to Engel and ILAE classiications respectively. These rates were almost same at the end of follow-up period (92% and 82% respectively). The completely seizure free rate at one year was 80% and decreased to 68% at the end of the follow-up. There was no mortality. Morbidity rate was 10% and none of them was permanent. Triple concordance of the noninvasive tests (neuropsychological tests, video- electroencephalography monitoring and magnetic resonance imaging) and favorable seizure outcome at the irst year were predictors of the ultimate seizure outcome (P=0.01 and P=0.04 respectively). coNclusioNs: Our indings demonstrated that anteromedial temporal lobectomy is a safe and effective treatment method in well-chosen patients with hippocampal sclerosis. This surgical procedure can be performed with a low rate of morbidity even in relatively new epilepsy surgery center.