Case 18: Metabolic Abnormalities After Failed Resective Temporal Epilepsy Surgery

2021 ◽  
pp. 91-94
Author(s):  
Valentina Garibotto ◽  
Maria Isabel Vargas ◽  
Serge Vulliemoz ◽  
Margitta Seeck
Keyword(s):  
Epilepsy Surgery ◽  
Metabolic Abnormalities ◽  
Temporal Epilepsy

European trends in epilepsy surgery

Neurology ◽  
2018 ◽  
Vol 91 (2) ◽  
pp. e96-e106 ◽  
Author(s):  
Maxime O. Baud ◽  
Thomas Perneger ◽  
Attila Rácz ◽  
Max C. Pensel ◽  
Christian Elger ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Disease Duration ◽  
Focal Epilepsy ◽  
Seizure Freedom ◽  
Early Referral ◽  
Temporal Epilepsy ◽  
Included Patient ◽  
Class 1 ◽  
Postsurgical Outcomes ◽  
Over Time

ObjectiveResective surgery is effective in treating drug-resistant focal epilepsy, but it remains unclear whether improved diagnostics influence postsurgical outcomes. Here, we compared practice and outcomes over 2 periods 15 years apart.MethodsSixteen European centers retrospectively identified 2 cohorts of children and adults who underwent epilepsy surgery in the period of 1997 to 1998 (n = 562) or 2012 to 2013 (n = 736). Data collected included patient (sex, age) and disease (duration, localization and diagnosis) characteristics, type of surgery, histopathology, Engel postsurgical outcome, and complications, as well as imaging and electrophysiologic tests performed for each case. Postsurgical outcome predictors were included in a multivariate logistic regression to assess the strength of date of surgery as an independent predictor.ResultsOver time, the number of operated cases per center increased from a median of 31 to 50 per 2-year period (p = 0.02). Mean disease duration at surgery decreased by 5.2 years (p < 0.001). Overall seizure freedom (Engel class 1) increased from 66.7% to 70.9% (adjusted p = 0.04), despite an increase in complex surgeries (extratemporal and/or MRI negative). Surgeries performed during the later period were 1.34 times (adjusted odds ratio; 95% confidence interval 1.02–1.77) more likely to yield a favorable outcome (Engel class I) than earlier surgeries, and improvement was more marked in extratemporal and MRI-negative temporal epilepsy. The rate of persistent neurologic complications remained stable (4.6%–5.3%, p = 0.7).ConclusionImprovements in European epilepsy surgery over time are modest but significant, including higher surgical volume, shorter disease duration, and improved postsurgical seizure outcomes. Early referral for evaluation is required to continue on this encouraging trend.

scholarly journals Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-8
Author(s):  
Abdulaziz Alsemari ◽  
Faisal Al-Otaibi ◽  
Salah Baz ◽  
Ibrahim Althubaiti ◽  
Hisham Aldhalaan ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Intractable Epilepsy ◽  
Research Centre ◽  
Mesial Temporal Sclerosis ◽  
Brain Scans ◽  
Temporal Epilepsy ◽  
Dual Pathology ◽  
Surgery Outcome ◽  
Postoperative Seizure

Purpose. To review the postoperative seizure outcomes of patients that underwent surgery for epilepsy at King Faisal Specialist Hospital & Research Centre (KFSHRC). Methods. A descriptive retrospective study for 502 patients operated on for medically intractable epilepsy between 1998 and 2012. The surgical outcome was measured using the ILAE criteria. Results. The epilepsy surgery outcome for temporal lobe epilepsy surgery (ILAE classes 1, 2, and 3) at 12, 36, and 60 months is 79.6%, 74.2%, and 67%, respectively. The favorable 12- and 36-month outcomes for frontal lobe epilepsy surgery are 62% and 52%, respectively. For both parietal and occipital epilepsy lobe surgeries the 12- and 36-month outcomes are 67%. For multilobar epilepsy surgery, the 12- and 36-month outcomes are 65% and 50%, respectively. The 12- and 36-month outcomes for functional hemispherectomy epilepsy surgery are 64.2% and 63%, respectively. According to histopathology diagnosis, mesiotemporal sclerosis (MTS) and benign CNS tumors had the best favorable outcome after surgery at 1 year (77.27% and 84.3%, resp.,) and 3 years (76% and 75%, resp.,). The least favorable seizure-free outcome after 3 years occurred in cases with dual pathology (66.6%). Thirty-four epilepsy patients with normal magnetic resonance imaging (MRI) brain scans were surgically treated. The first- and third-year epilepsy surgery outcome of 17 temporal lobe surgeries were (53%) and (47%) seizure-free, respectively. The first- and third-year epilepsy surgery outcomes of 15 extratemporal epilepsy surgeries were (47%) and (33%) seizure-free. Conclusion. The best outcomes are achieved with temporal epilepsy surgery, mesial temporal sclerosis, and benign CNS tumor. The worst outcomes are from multilobar surgery, dual pathology, and normal MRI.

The psychiatric risks of temporal epilepsy surgery. What should patients be told?

2018 ◽  
Vol 78 ◽  
pp. 315 ◽  
Author(s):  
Bengi Kansu ◽  
William Owen Pickrell ◽  
Khalid Hamandi
Keyword(s):  
Epilepsy Surgery ◽  
Temporal Epilepsy

scholarly journals Contribution of memory evaluation in temporal epilepsy surgery

2020 ◽  
pp. 357-360
Author(s):  
H. Lelklou ◽  
M. Djellaoui ◽  
H. Si Ahmed ◽  
B. Yakoubi
Keyword(s):  
Surgical Treatment ◽  
Epilepsy Surgery ◽  
Epileptogenic Zone ◽  
Memory Decline ◽  
Crucial Step ◽  
Temporal Epilepsy ◽  
Memory Assessment

Memory assessment is a crucial step in the pre-surgical assessment of temporal epilepsy. Indeed, it participates to a certain extent in the process of localization of the epileptogenic zone and also makes it possible to anticipate the possible risks of surgical treatment on the memory.We propose to specify the contribution of memory evaluation in 60 patients’ candidates for temporal epilepsy surgery, in terms of localization of the “epileptogenic zone” and in the appreciation of the risk of postoperative memory decline.

How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery?

2016 ◽  
Vol 18 (2) ◽  
pp. 137-147 ◽  
Author(s):  
Lizbeth Hernández-Ronquillo ◽  
Samantha Buckley ◽  
Lady Diana Ladino ◽  
Adam Wu ◽  
Farzad Moien-Afshari ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Temporal Epilepsy

scholarly journals Temporal lobe regions essential for preserved picture naming after left temporal epilepsy surgery

Epilepsia ◽  
2020 ◽  
Vol 61 (9) ◽  
pp. 1939-1948
Author(s):  
Jeffrey R. Binder ◽  
Jia‐Qing Tong ◽  
Sara B. Pillay ◽  
Lisa L. Conant ◽  
Colin J. Humphries ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Picture Naming ◽  
Temporal Epilepsy

scholarly journals Cerebellar hemorrhage as a complication of temporal lobectomy for refractory medial temporal epilepsy: report of three cases

2004 ◽  
Vol 62 (2b) ◽  
pp. 519-522 ◽  
Author(s):  
Luciano de Paola ◽  
André R. Troiano ◽  
Francisco M.B. Germiniani ◽  
Patrícia Coral ◽  
Marcus V. Della Coletta ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Cerebral Spinal Fluid ◽  
Rare Condition ◽  
Spinal Fluid ◽  
Temporal Lobectomy ◽  
Cerebellar Hemorrhage ◽  
Remote Cerebellar Hemorrhage ◽  
Temporal Epilepsy

Cerebellar hemorrhage is listed among the potential complications following neurosurgical pro ce dures. In this scenario it is usually reported as a rare condition. However, it seems that epilepsy surgery pa tients are somewhat more prone to this kind of complication, compared to other surgical groups. Head po si tioning, excessive cerebral spinal fluid draining and the excision of non-expanding encephalic tissue (or combinations among the three) are likely to be cause underlying remote cerebellar hemorrhage. Out of the 118 ATL/AH performed at our institution, between 1996 and 2002, we identified 3 (2.5%) patients pre sen ting with cerebellar hemorrhage. We report on such cases and review the literature on the topic.

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