Race/ethnicity, sex, and socioeconomic status as predictors of outcome after surgery for temporal lobe epilepsy.
BACKGROUND
Several risk factors have been attributed to seizure recurrence after surgery. It is unknown whether race/ethnicity plays a role in outcome.


OBJECTIVE
To evaluate whether race/ethnicity plays a role in seizure recurrence after surgery.


METHODS
Cohort study.


METHODS
We evaluated data obtained from the epilepsy centers at the University of Alabama at Birmingham and New York University, New York, NY.


METHODS
All patients included had a diagnosis of mesial temporal sclerosis and underwent temporal lobectomy.


METHODS
Occurrence of seizure after surgery was registered 1 year after surgery. We used multiple logistic regression analysis to model the presence of seizure recurrence after surgery and generated odds ratios (ORs) for seizure recurrence after surgery for African American and Hispanic patients relative to white patients. An unadjusted model incorporated only race/ethnicity as the independent variable, and an adjusted model included socioeconomic status, age, duration of epilepsy, education, history of febrile seizures, sex, handedness, lateralization of epileptogenic focus, and number of antiepileptics as the independent variables.


RESULTS
Two hundred fifty-two patients underwent surgical treatment with pathological confirmation of mesial temporal sclerosis. No differences were found between racial/ethnic groups in terms of seizure recurrence in any models. For African American patients, the ORs were 0.9 (95% confidence interval [CI], 0.4-2.1) for the unadjusted model and 0.8 (95% CI, 0.3-2.0) for the adjusted model; for Hispanic patients, the ORs were 1.6 (95% CI, 0.8-3.2) for the unadjusted model and 1.1 (95% CI, 0.5-2.6) for the adjusted model, relative to white patients.


CONCLUSIONS
Our data suggest that although sex appears to play a role in the outcomes of surgery for temporal lobe epilepsy, race and socioeconomic status do not.
Burneo
Jorge G
JG
Epilepsy Programme, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada..
Black
Lorie
L
Martin
Roy
R
Devinsky
Orrin
O
Pacia
Steve
S
Faught
Edward
E
Vasquez
Blanca
B
Knowlton
Robert C
RC
Luciano
Daniel
D
Doyle
Werner
W
Najjar
Sohuel
S
Kuzniecky
Ruben I
RI
D000328:Adult; D015331:Cohort Studies; D004833:Epilepsy, Temporal Lobe / Q000208:ethnology* / Q000503:physiopathology / Q000601:surgery*; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D016896:Treatment Outcome