Very long-term outcome in resected and non-resected patients with temporal lobe epilepsy with medial temporal lobe sclerosis: A multiple case-study

Object The aim of this study was to evaluate the long-term efficacy of temporal lobe epilepsy (TLE) surgery and potential risk factors for seizure recurrence after surgery. Methods This retrospective study included 434 consecutive adult patients who underwent TLE surgery at Bethel Epilepsy Centre between 1991 and 2002. Results Hippocampal sclerosis was found in 62% of patients, gliosis in 17.3%, tumors in 20%, and focal cortical dysplasia (FCD) in 6.9%. Based on a Kaplan-Meier analysis, the probability of Engel Class I outcome for the patients overall was 76.2% (95% CI 71–81%) at 6 months, 72.3% (95% CI 68–76%) at 2 years, 71.1% (95% CI 67–75%) at 5 years, 70.8% (95% CI 65–75%) at 10 years, and 69.4% (95% CI 64–74%) at 16 years postoperatively. The likelihood of remaining seizure free after 2 years of freedom from seizures was 90% (95% CI 82–98%) for 16 years. Seizure relapse occurred in all subgroups. Patients with FCD had the highest risk of recurrence (hazard ratio 2.15, 95% CI 0.849–5.545). Predictors of remission were the presence of hippocampal atrophy on preoperative MR imaging and a family history of epilepsy. Predictors of relapse were the presence of bilateral interictal sharp waves and versive seizures. Six-month follow-up electroencephalography predicted relapse in patients with FCD. Short epilepsy duration was predictive of seizure remission in patients with tumors and gliosis; 28.1% of patients were able to discontinue antiepileptic medications without an increased risk of seizure recurrence (hazard ratio 1.05, 95% CI 0.933–1.20). Conclusions These findings highlight the role of etiology in prediction of long-term outcome after TLE surgery.

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Long-term outcome of mild mesial temporal lobe epilepsy

Neurology ◽

10.1212/wnl.0000000000002674 ◽

2016 ◽

Vol 86 (20) ◽

pp. 1904-1910 ◽

Cited By ~ 21

Author(s):

Angelo Labate ◽

Umberto Aguglia ◽

Giovanni Tripepi ◽

Laura Mumoli ◽

Edoardo Ferlazzo ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Mesial Temporal Lobe Epilepsy ◽

Term Outcome ◽

Long Term Outcome ◽

Mesial Temporal Lobe

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Long-term outcome of gamma-knife surgery in temporal lobe epilepsy

Epilepsy Research ◽

10.1016/j.eplepsyres.2008.03.003 ◽

2008 ◽

Vol 80 (1) ◽

pp. 23-29 ◽

Cited By ~ 30

Author(s):

Sylvain Rheims ◽

Catherine Fischer ◽

Philippe Ryvlin ◽

Jean Isnard ◽

Marc Guenot ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Gamma Knife ◽

Temporal Lobe ◽

Gamma Knife Surgery ◽

Term Outcome ◽

Long Term Outcome

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Long-term outcome and determinants of quality of life after temporal lobe epilepsy surgery in adults

Epilepsy Research ◽

10.1016/j.eplepsyres.2009.06.008 ◽

2009 ◽

Vol 86 (2-3) ◽

pp. 191-199 ◽

Cited By ~ 46

Author(s):

Alaa Eldin Elsharkawy ◽

Theodor May ◽

Rupprecht Thorbecke ◽

Steffi Koch-Stoecker ◽

Antonia Villagran ◽

...

Keyword(s):

Quality Of Life ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Term Outcome ◽

Long Term Outcome

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Long-term outcome and neuroradiologic changes after multiple hippocampal transection combined with multiple subpial transection or lesionectomy for temporal lobe epilepsy

Epilepsia ◽

10.1111/epi.13374 ◽

2016 ◽

Vol 57 (6) ◽

pp. 931-940 ◽

Cited By ~ 4

Author(s):

Kenichi Usami ◽

Mayumi Kubota ◽

Kensuke Kawai ◽

Naoto Kunii ◽

Takeshi Matsuo ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Term Outcome ◽

Long Term Outcome

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Chronic neuroangiostrongyliasis: case study of chronic presentations in Hawaii

Parasitology ◽

10.1017/s0031182020001651 ◽

2020 ◽

pp. 1-6

Author(s):

Bernard C. Meyer

Keyword(s):

Clinical Symptoms ◽

Personal Relationships ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome ◽

Residual Symptoms ◽

Common Features ◽

Muscular Pain

Abstract This paper describes chronic features of neuroangiostrongyliasis (NAS), a long-term outcome of the disease that has not been adequately described. Current and past literature is predominantly limited to acute manifestations of NAS, and mention of chronic, ongoing clinical symptoms is usually limited to brief notes in a discussion of severe cases. This study investigated the long-term outcomes in ten individuals who were diagnosed with acute neuroangiostrongyliasis in Hawaii between 2009 and 2017. The study demonstrates a significant number of persons in Hawaii sustain residual symptoms for many years, including troublesome sensory paresthesia (abnormal spontaneous sensations of skin experienced as ‘burning, pricking, pins and needles’; also described as allodynia or hyperesthesia) and extremity muscle pains. As a consequence, employment and economic hardships, domestic relocations, and psychological impairments affecting personal relationships occurred. The study summarizes common features of chronic disease, sensory paresthesia and hyperesthesia, diffuse muscular pain, insomnia, and accompanying emotional distress; highlights the frequently unsuccessful endeavours of individuals struggling to find effective treatment; proposes pathogenic mechanisms responsible for prolonged illness including possible reasons for differences in disease presentation in Hawaii compared to Southeast Asia.

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