Main complications of epilepsy surgery performed in a single center in Latin America

Describe the main medical and neurological complications following epilepsy surgery at a tertiary care center in Latin America.

A retrospective study was conducted from 2006 to 2013 at the National Institute of Neurology and Neurosurgery in Mexico City. Patients aged over 18 years with drug-resistant epilepsy who underwent surgery and had a minimum follow-up of one year were included. Statistical analyses performed were Fisher's exact test, Pearson's Chi-square, and one-way ANOVA with Tukey post hoc for multiple comparisons.

Of 204 clinical records reviewed, 165 met inclusion criteria, and 95 (57.6%) underwent epilepsy surgery. Most patients (73.7%) had temporal lobectomy with amygdalohippocampectomy, followed by lesionectomy (9.5%), corpus callosotomy (15.8%), and one (0.6%) vagus nerve stimulator implantation. Minor medical complications occurred in 6.3% of patients, with extracranial infection (4.2%) and CSF fistula (2.1%) being the most common. Minor neurological complications were observed in 29.5%, including cranial nerve deficits (2.1%), intracranial hematoma (2.1%), and quadrantanopia (25.3%). One patient (1.1%) experienced a major complication (hemianopsia).

This large LATAM cohort highlights the low complication rate of epilepsy surgery. Early referral of DRE patients demonstrated statistically significant favorable outcomes and fewer postoperative complications. Despite its demonstrated safety when performed by experienced specialists, its underutilization persists due to access barriers, even though untreated epilepsy poses significantly greater risks.