title: Long-term seizure outcome for international consensus classification of hippocampal sclerosis: a survival analysis.
abstract: OBJECTIVE
  Surgery is regarded as a common treatment option for patients with mesial temporal lobe epilepsy (MTLE) as a result of hippocampal sclerosis (HS). However, approximately one-third of patients with intractable epilepsy did not become seizure-free after tailored resection strategies. It would be compelling to identify predictive factors of postoperative seizure outcomes. Our aim was to assess the correlation between HS classification and long-term postoperative seizure outcome in patients with MTLE due to HS.
  
  
  METHODS
  To investigate HS classification, semi-quantitative analysis and immunohistochemical staining of neuronal nuclei (NeuN) were performed on 100 postoperative hippocampal specimens. All patients had a 1-7 year postoperative follow-up. The postoperative seizure outcome was evaluated using International League Against Epilepsy (ILAE) outcome classification.
  
  
  RESULTS
  Three types of HS were recognized. The highest incidence of initial precipitating injury (IPI) was noted in the HS ILAE type 1 group (53.1%). The most favorable long-term seizure outcome was also noted in the HS ILAE type 1 group. The shortest epilepsy duration was recorded in the HS ILAE type 2 group (mean epilepsy duration=6.64 ± 5.83 years). The completely seizure free rate of patients in all groups declined with an increase in time.
  
  
  CONCLUSIONS
  Our study for the first time demonstrated a significant correlation between HS ILAE types and long-term postoperative seizure outcome in patients with MTLE due to HS. Therefore, HS ILAE types have predictive value in long-term seizure outcome following epilepsy surgery.
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Na
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Ge
authors.affiliation: Department of Neurosurgery, New York University Langone Medical Center and School of Medicine, New York, NY, USA.
authors.forename: Chen
authors.initials: C
authors.lastname: Shi
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Song
authors.initials: S
authors.lastname: Pu
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Haiyang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Chuncheng
authors.initials: C
authors.lastname: Xie
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Minwei
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
authors.forename: Jiabin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Section of Neurosurgery/Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA.
authors.forename: Changbin
authors.initials: C
authors.lastname: Shi
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China. Electronic address: linzhiguonm@gmail.com.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D034961:Antigens, Nuclear / Q000378:metabolism; D001930:Brain Injuries / Q000150:complications; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004827:Epilepsy / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000378:metabolism; D012598:Sclerosis / Q000145:classification* / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D012640:Seizures / Q000209:etiology / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D034961:Antigens, Nuclear; D009419:Nerve Tissue Proteins; C506808:neuronal nuclear antigen NeuN, human
keywords: Hippocampal sclerosis; International consensus classification; Long-term seizure outcome; Mesial temporal lobe epilepsy