Predicting epilepsy surgery outcome.
Détails
ID Serval
serval:BIB_9E0C169E5C38
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Predicting epilepsy surgery outcome.
Périodique
Current Opinion In Neurology
ISSN
1473-6551 (Electronic)
ISSN-L
1350-7540
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
29
Numéro
2
Pages
182-188
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Document Type: Review
Publication Status: ppublish
Document Type: Review
Résumé
PURPOSE OF REVIEW: This review summarizes recent evidence on the seizure, safety, cognitive and psychosocial outcomes of epilepsy surgery and their predictors.
RECENT FINDINGS: Risks of serious surgical complications have dramatically decreased over years to drop below 1% for temporal lobe resections. Although chances of postoperative seizure freedom largely vary between recent series, some data suggest that long-term seizure control might be achieved in over 80% of patients with mesial temporal lobe epilepsy or neocortical epilepsy associated with type 2 focal cortical dysplasia, and in up to two-thirds of patients with extratemporal lobe epilepsy. In the same conditions, some recent series challenge the classic view that a normal MRI is associated with worse outcome, an important finding given the greater proportion of MRI-negative patients now considered for epilepsy surgery.
SUMMARY: These provocative findings appear to partly reflect the advances in the optimal use or postprocessing of neuroimaging data, as well as the identification of temporal plus epilepsy. This latter condition, which is characterized by normal MRI in half of patients and very poor outcome following anterior temporal lobectomy, was found to represent the main predictor of temporal lobe epilepsy surgery failures. Postoperative cognitive and quality-of-life outcomes, which partly depend on seizure control, are also influenced by antiepileptic drugs and psychiatric comorbidities.
RECENT FINDINGS: Risks of serious surgical complications have dramatically decreased over years to drop below 1% for temporal lobe resections. Although chances of postoperative seizure freedom largely vary between recent series, some data suggest that long-term seizure control might be achieved in over 80% of patients with mesial temporal lobe epilepsy or neocortical epilepsy associated with type 2 focal cortical dysplasia, and in up to two-thirds of patients with extratemporal lobe epilepsy. In the same conditions, some recent series challenge the classic view that a normal MRI is associated with worse outcome, an important finding given the greater proportion of MRI-negative patients now considered for epilepsy surgery.
SUMMARY: These provocative findings appear to partly reflect the advances in the optimal use or postprocessing of neuroimaging data, as well as the identification of temporal plus epilepsy. This latter condition, which is characterized by normal MRI in half of patients and very poor outcome following anterior temporal lobectomy, was found to represent the main predictor of temporal lobe epilepsy surgery failures. Postoperative cognitive and quality-of-life outcomes, which partly depend on seizure control, are also influenced by antiepileptic drugs and psychiatric comorbidities.
Pubmed
Web of science
Création de la notice
20/02/2016 16:18
Dernière modification de la notice
20/08/2019 15:04