Predictors of seizure outcome after temporal lobectomy for intractable epilepsy.
OBJECTIVE
To assess predictors of outcome of temporal lobectomy for intractable epilepsy.


METHODS
In 63 adult patients operated with anterior temporal lobectomy during 198892, we used logistic regression analysis to assess predictors of being seizure-free (Engel's class I) 2 years after surgery. As potential predictors, we included the following variables: gender, age at operation, age at onset of seizures, epilepsy duration, etiology, generalized vs not generalized seizures, seizure frequency, intelligence quotient, ictal electroencephalography, magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), side of resection, and extent of the resection.


RESULTS
About 44% of the surgery patients were seizure-free (Engel's class I) 2 years after surgery. In multivariate analysis (n = 55), MRI pathology defined as atrophy in the temporal lobe, angioma, tumor or mesial temporal sclerosis (odds ratio, OR 7.4, 95%CI: 1.7-32.9) and extent of the hippocampal resection (increase of 1 cm) (OR 2.2, 95%CI: 1.1-4.6) predicted being seizure-free.


CONCLUSIONS
Focal pathology in preoperative MRI and the extent of the hippocampal resection were the only significant predictors of being seizure-free after 2 years.
Stavem
K
K
Foundation for Health Services Research (HELTEF), Akershus University Hospital, Nordbyhagen, Norway. knut.stavem@klinmed.uio.no
Bjørnaes
H
H
Langmoen
I A
IA
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy; D018572:Disease-Free Survival; D004828:Epilepsies, Partial / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004829:Epilepsy, Generalized / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome