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Surgical treatment for epilepsy: a retrospective Swedish multicenter study.

C:son Silander, H (author)
Blom, S (author)
Malmgren, Kristina, 1952 (author)
Gothenburg University,Göteborgs universitet,Institutionen för klinisk neurovetenskap,Institute of Clinical Neurosciences
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Rosén, Ingmar (author)
Uvebrant, Paul, 1951 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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 (creator_code:org_t)
1997
1997
English.
In: Acta neurologica Scandinavica. - 0001-6314. ; 95:6, s. 321-30
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Keyword

Adolescent
Adult
Age Factors
Age of Onset
Anticonvulsants
therapeutic use
Cerebral Cortex
physiopathology
surgery
Cerebral Decortication
adverse effects
methods
standards
Child
Child
Preschool
Cohort Studies
Drug Resistance
Epilepsy
classification
complications
drug therapy
surgery
Female
Follow-Up Studies
Frontal Lobe
surgery
Humans
Infant
Male
Middle Aged
Outcome Assessment (Health Care)
standards
Retrospective Studies
Severity of Illness Index
Sweden
Temporal Lobe
physiopathology
surgery

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ref (subject category)
art (subject category)

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