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Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
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Postoperative seizures after extratemporal resections and hemispherectomy in pediatric epilepsy

J Mani1, A Gupta, E Mascha

  • 1Department of Neurology, Cleveland Clinic Foundation, OH 44195, USA.

Neurology
|April 12, 2006
PubMed

Insights

Acute postoperative seizures (APOS) affect 26% of children after epilepsy surgery, with higher risk after extratemporal cortical resection. These seizures predict poor long-term seizure control, indicating they are not benign.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Intractable epilepsy in children often necessitates surgical intervention.
  • Extratemporal cortical resection (ETR) and hemispherectomy (HS) are surgical options for severe epilepsy.
  • Understanding postoperative seizure patterns is crucial for patient management and outcome prediction.

Purpose of the Study:

  • To determine the incidence and risk factors of acute postoperative seizures (APOS) within the first week following ETR and HS in pediatric patients.
  • To evaluate the predictive value of APOS on long-term seizure outcomes after these epilepsy surgeries.
  • To provide data for counseling families regarding prognosis after epilepsy surgery.

Main Methods:

  • Retrospective analysis of 132 children (<18 years) who underwent ETR or HS for intractable epilepsy (1995-2002).
  • Collection of data on APOS characteristics and seizure outcomes at 6, 12, and 24 months post-surgery.
  • Statistical analysis using univariate logistic regression for risk factors and life table/log rank tests for seizure outcomes.

Main Results:

  • 34 out of 132 patients (26%) experienced APOS.
  • APOS were significantly more frequent after ETR (26/71) compared to HS (8/61) (p < 0.01).
  • APOS independently predicted poor long-term seizure outcome (Engel class I) at 2 years, with significantly lower odds (0.13-0.27) compared to non-APOS cases.

Conclusions:

  • Acute postoperative seizures occur in 26% of pediatric epilepsy surgery patients, with a higher incidence after ETR than HS.
  • APOS are a significant predictor of unfavorable seizure outcomes at 6, 12, and 24 months post-surgery.
  • The findings highlight the importance of considering APOS as a non-benign event in research and clinical practice for pediatric epilepsy surgery.
Abstract

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