title: Long term outcome in patients not initially seizure free after resective epilepsy surgery.
abstract: OBJECTIVE
  To assess the long-term seizure outcome and find predictors of outcome for patients who were not initially seizure free 6 months after epilepsy surgery.
  
  
  METHODS
  We retrospectively reviewed all adult patients who underwent epilepsy surgery at the Epilepsy Center Bethel, between 1992 and 2003. There were 266 patients included in this analysis.
  
  
  RESULTS
  Of the 266 patients who were included in this study, the probability of becoming seizure free was 12% (95%CI 8-16%) after 2 years, 19.5% (95%CI 15-24%) after 5 years and 34.7% (95%CI 28-41%) after 10 years. In patients who had auras only, the probability of being seizure free was 18.2% after 2 years, 25.5% after 5 years, and 39.1% after 10 years. In the multiregression analysis, the EEG carried out 2 years after surgery, a psychic aura, the frequency of postoperative focal seizures and hypermotor seizures predicted seizure remission in the long-term outcome.
  
  
  CONCLUSIONS
  The frequency and type of postoperative seizures are critical determinants for long-term outcome. Seizure semiology may be the clue to a precise diagnosis and long-term prognosis of epilepsy.
authors.affiliation: Department of Presurgical Evaluation, Bethel Epilepsy Center, Krankenhaus Mara, Maraweg 21, 33617 Bielefeld, Germany. alaa.elsharkawy@mara.de
authors.forename: Alaa Eldin
authors.initials: AE
authors.lastname: Elsharkawy
authors.forename: Terttu A
authors.initials: TA
authors.lastname: Pietilä
authors.forename: Abdel Hamid
authors.initials: AH
authors.lastname: Alabbasi
authors.forename: Heinz
authors.initials: H
authors.lastname: Pannek
authors.forename: Alois
authors.initials: A
authors.lastname: Ebner
mesh_terms: D000293:Adolescent; D000328:Adult; D004569:Electroencephalography / Q000639:trends; D004827:Epilepsy / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000639:trends*; D011184:Postoperative Period; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult