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Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country

机译:癫痫手术系列:来自发展中国家的502名连续患者的研究

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Purpose. To review the postoperative seizure outcomes of patients that underwent surgery for epilepsy at King Faisal Specialist Hospital & Research Centre (KFSHRC).Methods. A descriptive retrospective study for 502 patients operated on for medically intractable epilepsy between 1998 and 2012. The surgical outcome was measured using the ILAE criteria.Results. The epilepsy surgery outcome for temporal lobe epilepsy surgery (ILAE classes 1, 2, and 3) at 12, 36, and 60 months is 79.6%, 74.2%, and 67%, respectively. The favorable 12- and 36-month outcomes for frontal lobe epilepsy surgery are 62% and 52%, respectively. For both parietal and occipital epilepsy lobe surgeries the 12- and 36-month outcomes are 67%. For multilobar epilepsy surgery, the 12- and 36-month outcomes are 65% and 50%, respectively. The 12- and 36-month outcomes for functional hemispherectomy epilepsy surgery are 64.2% and 63%, respectively. According to histopathology diagnosis, mesiotemporal sclerosis (MTS) and benign CNS tumors had the best favorable outcome after surgery at 1 year (77.27% and 84.3%, resp.,) and 3 years (76% and 75%, resp.,). The least favorable seizure-free outcome after 3 years occurred in cases with dual pathology (66.6%). Thirty-four epilepsy patients with normal magnetic resonance imaging (MRI) brain scans were surgically treated. The first- and third-year epilepsy surgery outcome of 17 temporal lobe surgeries were (53%) and (47%) seizure-free, respectively. The first- and third-year epilepsy surgery outcomes of 15 extratemporal epilepsy surgeries were (47%) and (33%) seizure-free.Conclusion. The best outcomes are achieved with temporal epilepsy surgery, mesial temporal sclerosis, and benign CNS tumor. The worst outcomes are from multilobar surgery, dual pathology, and normal MRI.
机译:目的。在金费萨尔专科医院和研究中心(KFSHRC)回顾接受癫痫手术患者的术后癫痫发作结局。一项描述性回顾性研究,针对1998年至2012年间502例因医学上难治性癫痫而手术的患者。采用ILAE标准对手术结局进行了评估。在12、36和60个月时,颞叶癫痫手术(ILAE 1、2和3级)的癫痫手术结果分别为79.6%,74.2%和67%。额叶癫痫手术的12个月和36个月有利结局分别为62%和52%。对于顶叶和枕叶癫痫手术,12个月和36个月的预后为67%。对于多叶癫痫手术,其12个月和36个月的结果分别为65%和50%。功能性半球切除术癫痫手术的12个月和36个月结果分别为64.2%和63%。根据组织病理学诊断,术后1年(分别为77.27%和84.3%)和3年(分别为76%和75%)的中颞叶硬化(MTS)和中枢神经系统肿瘤具有最佳的预后。双重病理情况下,3年后无癫痫发作的效果最低(66.6%)。接受了34例磁共振成像(MRI)脑扫描正常的癫痫患者的手术治疗。 17例颞叶手术的第一年和第三年癫痫手术结局分别为(53%)和(47%)无癫痫发作。 15例颞外癫痫手术的第一年和第三年癫痫手术结局为(47%)和(33%)无癫痫发作。颞癫手术,颞叶内侧硬化和良性中枢神经系统肿瘤可达到最佳效果。结果最差的是多叶手术,双重病理和MRI正常。

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