title: Outcome of surgery for temporal lobe epilepsy in adults - A cohort study.
abstract: BACKGROUND
  The aim of the current study was to evaluate the factors associated with post-operative outcome in patients with temporal lobe epilepsy (TLE) undergoing Surgery.
  
  
  METHODS
  We analyzed data of 288 consecutive patients operated for drug-resistant TLE. All the patients had at least one year post surgery follow-up. Logistic regression model was used to evaluate the predictive value of different factors for outcome.
  
  
  RESULTS
  The mean age at onset of epilepsy of the study population was 15.51 ± 9.79 years; whereas the mean age at surgery was 32.16 ± 9.45 years, with 125 (43.4%) women. The age at surgery was significantly lower in the patients with favourable outcome (30.26 ± 9.05 vs. 34.06 ± 9.85 years; p = 0.007). The mean duration of epilepsy with age of onset below 12 years was higher than the rest (19.84 ± 7.30 vs. 13.00 ± 8.45 years; p < 0.001). The histopathology showed hippocampal sclerosis in 203 (70.4%) of the patients; isolated focal cortical dysplasia was associated with unfavourable outcome (9.3% vs.2.6%; p = 0.036). The duration of follow up ranged from 1 to 10.3 years. Three patients died late in the follow up. At the last follow 73% were seizure free and Engel's favourable outcome was noted in 82%. Duration of epilepsy greater than ten years (β = 6.997; 95%CI; 2.254-21.715; p = 0.01), younger age of onset of epilepsy (β = 1.07; 95%CI; 1.014-1.132; p = 0.015) and acute post operative seizures (APOS) (β = 4.761; 95%CI; 1.946-11.649; p = 0.001) were the predictors of unfavourable outcome.
  
  
  CONCLUSIONS
  Following surgery for TLE, 73% were seizure free and Engel's favourable outcome was noted in 82%. The predictors of unfavourable outcome were younger age of onset, pronged duration and of epilepsy and APOS.
authors.affiliation: Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 03, Telangana, India. Electronic address: sita_js@hotmail.com.
authors.forename: Sita
authors.initials: S
authors.lastname: Jayalakshmi
authors.affiliation: Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 03, Telangana, India.
authors.forename: Sudhindra
authors.initials: S
authors.lastname: Vooturi
authors.affiliation: Department of Radiology, Vijaya Diagnostic Centre, Himayath Nagar, Hyderabad - 29, Telangana, India.
authors.forename: Rammohan
authors.initials: R
authors.lastname: Vadapalli
authors.affiliation: Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 03, Telangana, India.
authors.forename: Shanmukhi
authors.initials: S
authors.lastname: Somayajula
authors.affiliation: Department of Pathology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 03, Telangana, India.
authors.forename: Sailaja
authors.initials: S
authors.lastname: Madigubba
authors.affiliation: Department of Neurosurgery, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 03, Telangana, India.
authors.forename: Manas
authors.initials: M
authors.lastname: Panigrahi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D016896:Treatment Outcome
keywords: Outcome; Predictors; Surgery; Temporal lobe epilepsy