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- C:son Silander, H, et al.
(författare)
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Surgical treatment for epilepsy: a retrospective Swedish multicenter study.
- 1997
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Ingår i: Acta neurologica Scandinavica. - 0001-6314. ; 95:6, s. 321-30
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Tidskriftsartikel (refereegranskat)abstract
- The characteristics of patients suffering from drug resistant epilepsy, including the results of the preoperative evaluation and epilepsy surgery were retrospectively analyzed in a Swedish multicenter 10-year cohort of children and adults. Altogether 152 patients (65 children and 87 adults) treated during the period 1980-1990 in three epilepsy centers were included and followed-up 2 years after surgery. Median age at onset of seizures was 4 years for the children and 12 years for the adults. A localization related epilepsy was present in 85% of the children and in 95% of the adults. The mean number of seizure types in the children was 1.7 (range 1-4) and in the adults 1.8 (range 1-4). The median monthly seizure frequency was 52 and 15 for children and adults respectively. Resective surgery was performed in 143 cases (94 temporal, 31 extratemporal, 9 multilobar and 9 major resection procedures) and palliative procedures in 16 cases (13 callosotomies and 3 stereotactic amygdalotomies). Postoperative neurological deficits were detected in 9% of the patients after temporal lobe resections and in 15% of the patients after extratemporal and multilobar resection procedures. Two years after resective surgery 53% of the children and 49% of the adults were seizure free. Another 25% of the patients had a more than 50% reduction of seizure frequency. In the postoperative non seizure free group of patients there was a negative correlation between decrease in weighted seizure severity and decrease in seizure frequency. This finding stresses the need for including other parameters than seizure frequency when evaluating the outcome of epilepsy surgery.
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- Eriksson, s, et al.
(författare)
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Surgical treatment of epilepsy--clinical, radiological and histopathological findings in 139 children and adults.
- 1999
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Ingår i: Acta neurologica Scandinavica. - 0001-6314. ; 99:1, s. 8-15
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Tidskriftsartikel (refereegranskat)abstract
- The present study relates clinical and radiological data to histopathological diagnoses in the first 139 patients (children and adults) in the G?teborg Epilepsy Surgery series. Temporal lobe resections were most common (54.0%) followed by frontal lobe (18.0%) and multilobar resections (11.5%). All histopathological specimens were re-evaluated in connection with this study. Parenchymal malformations and atrophic-gliotic lesions were the most common histopathological findings. Microdysgenesis was more common than major malformations (24.5% versus 11.5%). When the MRI scans were blindly re-evaluated the MRI findings correlated with histopathological diagnosis in all of the vascular malformations, in 77.8% of the tumours, in 76.5% of the cases with hippocampal sclerosis but only in 28.6% of the major cortical development malformations. Hemispherectomies carried the best seizure outcome prognosis followed by temporal lobe resections (75.0% versus 57.3% seizure free 2 years after surgery). Vascular malformations carried the best, and microdysgenesis the worst prognosis (76.9% versus 39.4% seizure free).
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- Nordborg, Claes, 1946, et al.
(författare)
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Microdysgenesis in surgical specimens from patients with epilepsy: occurrence and clinical correlations.
- 1999
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Ingår i: Journal of neurology, neurosurgery, and psychiatry. - 0022-3050. ; 67:4, s. 521-4
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Tidskriftsartikel (refereegranskat)abstract
- Malformations of cortical development are commonly associated with epilepsy. In the first 139 consecutive patients in the G?teborg epilepsy surgery series, parenchymal malformations were found in 56. 1% of the children and in 23.1% of the adults. Microdysgenesis (MDG), which was the most common parenchymal malformation, was found in 35. 1% of the children and in 16.7% of the adults. The aim of this study was to identify clinical characteristics of patients with MDG. Mental retardation was found to be significantly more common in patients with major parenchymal malformations and in patients with MDG compared with patients without parenchymal malformations. Patients with major parenchymal malformations as well as patients with MDG also had a significantly earlier onset of seizures than patients without parenchymal malformations, also when adjusting for mental retardation. Patients with MDG were in these clinical aspects shown to closely resemble patients with major malformations. These findings suggest that MDG is a pathoanatomical entity of clinical relevance, with implications both in mental retardation and in epileptogenesis.
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- Silander, Hans C.-Son, et al.
(författare)
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[Surgical treatment is efficient in epilepsy]
- 1997
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Ingår i: Läkartidningen. - 0023-7205. ; 94:24, s. 2283-6
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Forskningsöversikt (refereegranskat)abstract
- Epilepsy surgery has a very long tradition, and recent advances in diagnostic and surgical procedures have enabled a number of patients with drug-resistant epilepsy to be treated successfully. In addition to the conventional clinical work-up, candidates for epilepsy surgery undergo evaluation by a multidisciplinary team using a battery of neuroimaging and neurophysiological procedures. Such teams have been established at all six university hospitals in Sweden.
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