Postoperative interictal epileptiform discharge within 1 month is associated with seizure recurrence after anterior temporal lobectomy.
To investigate the relationship of interictal epileptiform discharges (IEDs) within 1 month of anterior temporal lobectomy (ATL) to seizure outcome, we reviewed data for 202 (107 left ATL, 95 right ATL) patients who had undergone ATL for mesial temporal epilepsy. Postoperative EEGs within 30 days and other preoperative variables were analyzed to examine the significant factors that determine freedom from disabling seizures. IEDs were noted in 29 (22.3%) of the 130 patients without seizures for 2 years after ATL compared with 31 (43.1%) of the 72 patients with recurrent seizures (P = 0.002). Postoperative IEDs remained an independent predictive factor for seizure outcome by logistic regression (adjusted OR = 2.38, 95% CI = 1.18-4.81, P = 0.016, 2 years postoperatively; adjusted OR = 2.22, 95% CI = 1.03-4.82, P = 0.043, 5 years postoperatively) and Cox hazard regression analysis (adjusted HR = 1.76, 95% CI = 1.18-2.62, P = 0.006) after controlling for other predicting factors (unilateral hippocampal atrophy, history of febrile seizures, and IQ scores). In this study, IEDs on the EEG obtained soon after surgery were associated with postoperative seizure recurrence. These results can be used in the assessment of risk of seizure recurrence after ATL.
Yu
Hsiang-Yu
HY
Department of Neurology, Taipei Veterans General Hospital, and National Yang-Ming University, Taiwan.
Yen
Der-Jen
DJ
Yiu
Chun-Hin
CH
Lin
Yung-Yang
YY
Kwan
Shang-Yeong
SY
Chen
Chien
C
Hsu
Sanford P C
SP
Shih
Yang-Hsin
YH
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology*; D013997:Time Factors; D055815:Young Adult