Long-term seizure outcome and risk factors for recurrence after extratemporal epilepsy surgery

摘要: PURPOSE: We aimed to assess long-term seizure outcome and risk factors for recurrence in a cohort of patients who have undergone extratemporal resection management refractory seizures. METHODS: Eighty-one underwent at Austin Health, Melbourne, Australia (1991-2004). Seizure was any postoperative disabling (complex partial [CPS] ± secondary generalization). Multivariate Cox proportional hazards regression models examined potential preoperative perioperative the associated with early seizures (≤ 28 days postsurgery). The change between frequency also measured. KEY FINDINGS: Median follow-up 10.3 years (range 1-17.7). probabilities freedom from (on or off antiepileptic medication) were 40.7% (95% confidence interval [CI] 30-51) 1 month, 23.5% CI 15-33) year, 14.7% 8-23) 5 postoperative. Reduction least 20% attained by 57% years. Of preoperative/perioperative factors, focal cortical dysplasia (FCD) type (hazard ratio [HR] 1.90, 95% 1.08-3.34, p = 0.025) incomplete (HR 1.71, 1.06-2.76, 0.028) independent risks. After surgery, an only factor higher 4.28 [2.42-7.57], 0.00). SIGNIFICANCE: Distinction subtypes dysplasia, which can be made using magnetic resonance imaging (MRI) criteria, may useful prognostication. Early after surgery are not benign markers that contribute recurrence. Most achieve substantial reduction frequency. Further study significance this terms surgical "success" otherwise is required.