title: Long-term outcome and predictors of resective surgery prognosis in patients with refractory extratemporal epilepsy.
abstract: OBJECTIVE
  We analyzed the long-term postoperative outcome and possible predictive factors of the outcome in surgically treated patients with refractory extratemporal epilepsy.
  
  
  METHODS
  We retrospectively analyzed 73 patients who had undergone resective surgery at the Epilepsy Center Brno between 1995 and 2010 and who had reached at least 1 year outcome after the surgery. The average age at surgery was 28.3±11.4 years. Magnetic resonance imaging (MRI) did not reveal any lesion in 24 patients (32.9%). Surgical outcome was assessed annually using Engel's modified classification until 5 years after surgery and at the latest follow-up visit.
  
  
  RESULTS
  Following the surgery, Engel Class I outcome was found in 52.1% of patients after 1 year, in 55.0% after 5 years, and in 50.7% at the last follow-up visit (average 6.15±3.84 years). Of the patients who reached the 5-year follow-up visit (average of the last follow-up 9.23 years), 37.5% were classified as Engel IA at each follow-up visit. Tumorous etiology and lesions seen in preoperative MRI were associated with significantly better outcome (p=0.035; p<0.01). Postoperatively, 9.6% patients had permanent neurological deficits.
  
  
  CONCLUSIONS
  Surgical treatment of refractory extratemporal epilepsy is an effective procedure. The presence of a visible MRI-detected lesion and tumorous etiology is associated with significantly better outcome than the absence of MRI-detected lesion or other etiology.
authors.affiliation: Epilepsy Center Brno, Department of Child Neurology, Brno University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic. Electronic address: petra.hanakova@fnbrno.cz.
authors.forename: Petra
authors.initials: P
authors.lastname: Hanáková
authors.affiliation: Epilepsy Center Brno, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Brázdil
authors.affiliation: Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic; Epilepsy Center Brno, Department of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Novák
authors.affiliation: Epilepsy Center Brno, Department of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Hemza
authors.affiliation: Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic; Epilepsy Center Brno, Department of Neurosurgery, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Chrastina
authors.affiliation: Epilepsy Center Brno, Department of Child Neurology, Brno University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Ošlejšková
authors.affiliation: Department of Pathology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Markéta
authors.initials: M
authors.lastname: Hermanová
authors.affiliation: Department of Radiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Marta
authors.initials: M
authors.lastname: Pažourková
authors.affiliation: Epilepsy Center Brno, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Rektor
authors.affiliation: Epilepsy Center Brno, Department of Child Neurology, Brno University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Epilepsy Center Brno, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Kuba
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Engel's classification; Epilepsy surgery; Extratemporal; Histopathology; Long-term outcome