[Does epilepsy surgery really lower mortality?]

Details

Serval ID
serval:BIB_8D575CB61F35
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
[Does epilepsy surgery really lower mortality?]
Journal
Neurochirurgie
Author(s)
Ryvlin P., Montavont A.
ISSN
0028-3770 (Print)
ISSN-L
0028-3770
Publication state
Published
Issued date
05/2008
Volume
54
Number
3
Pages
282-6
Language
english
Notes
Ryvlin, P
Montavont, A
fre
English Abstract
Review
France
Neurochirurgie. 2008 May;54(3):282-6. doi: 10.1016/j.neuchi.2008.02.047. Epub 2008 Apr 16.
Abstract
Patients with epilepsy suffer from a two to three fold increased death rate as compared to age and sex matched control population. This increased risk culminate to five fold in patients with drug resistant partial epilepsy eligible for epilepsy surgery, with the majority of deaths classified as sudden unexpected death in epilepsy (SUDEP). The pathophysiology of SUDEP remains uncertain, but all witnessed cases occurred during or immediately after a seizure. Several studies have evaluated the impact of epilepsy surgery on the risk of seizure related death and SUDEP. Four series have concentrated on operated patients, and have compared the death rates in those seizure free and non seizure free post-operatively. Three of these studies reported a significantly lower risk of SUDEP in patients cured by surgery as compared to those still seizing. Four other series have compared the mortality in surgically versus medically treated patients with refractory partial epilepsy. Three of these studies failed to show any significant difference in death or SUDEP rates between operated and and non operated patients. All the above series suffer various types of methological limitations, hampering any definite conclusion regarding the impact of epilepsy surgery on mortality. The launching of novel and large multicentric studies, which address the pitfalls of prior series, should allow to provide conclusive results within the next three years.
Keywords
Anticonvulsants/therapeutic use, Drug Resistance, Epilepsy/drug therapy/*mortality/*surgery, Humans, *Neurosurgical Procedures, Temporal Lobe/pathology/surgery, Treatment Outcome
Pubmed
Create date
29/11/2018 13:37
Last modification date
20/08/2019 15:51
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