When is a postoperative seizure equivalent to “epilepsy recurrence” after epilepsy surgery?

摘要: Summary Purpose:  Up to one-half of epilepsy surgery patients will have at least one seizure after surgery. We aim characterize the prognosis following a first postoperative seizure, and provide criteria allowing early identification recurrent refractory epilepsy. Methods:  Analyzing 915 operated on between 1990 2007, we studied 276 who had ≥1 beyond immediate period. The probability subsequent seizures was calculated using survival analysis. Patients were divided into seizure-free (no for ≥1 year) (persistent seizures) analyzed multivariate regression analysis. Results:  After 50% recurrence within 1 month 77% year before risk slowed down additional 2–3% increments every two years. second 2 weeks, 78% 2 months, 83% 6 months. Having both six months [odds ratio (OR) 4.04; 95% confidence interval (CI) 2.05–8.40; p = 0.0001], an unprovoked initial (OR 3.92; CI 2.13–7.30; p < 0.0001), ipsilateral spikes 6-months electroencephalography (EEG) 2.05; 1.10–3.88; p = 0.025) predicted poorer outcome, with all three factors becoming refractory. All cryptogenic developed refractoriness. Discussion:  Seizures recur in most present their event, one-third eventually regaining seizure-freedom. Etiology epileptiform activity EEG may predict medical refractoriness.