title: Predictors of prognosis in patients with temporal lobe epilepsy after anterior temporal lobectomy.
abstract: The aim of this study was to evaluate the predictive value of prognostic factors for the surgical outcome of patients with mesial temporal lobe epilepsy (MTLE) using Engel seizure classification. The clinical data of 121 patients with MTLE who underwent anterior temporal lobectomy (ATL) and received a 1-year minimum follow-up were collected between January 2005 and December 2008. Patients were divided into seizure and seizure-free groups according to the Engel seizure classification. Univariate analysis and multivariate logistic regression analysis were used to analyze the potential predictive and prognostic factors, including medical history, clinical features of seizures, magnetic resonance imaging (MRI) and video-electroencephalogram (EEG) monitoring results. Univariate analysis indicated no statistically significant differences in gender, age at seizure onset, age at surgery, history of traumatic brain injury, perinatal anoxia, intracranial infection, family history of seizure, auras or site of surgery between the two groups; however, significant differences were detected in pre-surgical seizure duration, history of febrile seizures, seizure types, MRI and video-EEG results. Multivariate logistic regression analysis demonstrated that a pre-surgical seizure duration of <10 years, history of positive febrile seizures, simple complex partial seizure, positive MRI results and unilateral local video-EEG spikes may be considered as predictors of a good prognosis. These results indicate that remission may be achieved in patients with MTLE via the collection of accurate clinical information and adequate pre-surgical evaluation.
authors.affiliation: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China.
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China.
authors.forename: Huancong
authors.initials: H
authors.lastname: Zuo
authors.affiliation: Department of Neurology, The Luhe Teaching Hospital, Capital Medical University, Beijing 101149, P.R. China.
authors.forename: Dan
authors.initials: D
authors.lastname: Yuan
authors.affiliation: Department of Psychiatry, The Second Municipal Hospital of Zaozhuang, Zaozhuang, Shandong 277100, P.R. China.
authors.forename: Yaxing
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Tiantan Hospital, Capital Medical University, Beijing 101149, P.R. China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Department of Neurosurgery, Changgung Hospital, Tsinghua University Medical Center, Beijing 100084, P.R. China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
keywords: anterior temporal lobectomy; mesial temporal lobe epilepsy; predictor; prognosis