Surgical treatment for epilepsy: a retrospective Swedish multicenter study.

• 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.

Nyckelord

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

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)