title: Significance of post-operative auras after temporal lobectomy: a surprising methodological trap.
abstract: We aimed to examine post-operative auras/simple partial seizures and the associated risk of seizure recurrence after temporal lobectomy. Included were 159 patients who underwent anterior temporal lobectomy (1995-2006) at Austin Health, Australia. Initial analyses used Cox regression. Post-hoc, exploratory analyses of aura and seizure patterns were undertaken. Initial analyses indicated that post-operative auras were not associated with subsequent disabling seizures (HR 0.65, 95%CI 0.4-1.1 p=0.08). However, post-hoc examination found data patterns that suggest that post-operative auras may have been under-reported when medical contact between these events was absent. These findings are relevant to current research, as similar methodology is commonly employed in post-operative outcome studies. Important implications include potential underestimation of seizure risk associated with auras. Carefully planned prospective studies are required to assess the risk associated with post-operative auras.
authors.affiliation: Epilepsy Research Centre, University of Melbourne, Australia.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Kinsella
authors.forename: Clare A
authors.initials: CA
authors.lastname: Averill
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Berkovic
authors.forename: Anne M
authors.initials: AM
authors.lastname: McIntosh
mesh_terms: D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D004827:Epilepsy / Q000209:etiology*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors