Surgical outcome of temporal plus epilepsy is improved by multilobar resection
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Surgical outcome of temporal plus epilepsy is improved by multilobar resection. / Barba, Carmen; Rheims, Sylvain; Minotti, Lorella; Grisotto, Laura; Chabardès, Stéphan; Guenot, Marc; Isnard, Jean; Pellacani, Simona; Hermier, Marc; Ryvlin, Philippe; Kahane, Philippe.
I: Epilepsia, Bind 63, Nr. 4, 2022, s. 769-776.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Surgical outcome of temporal plus epilepsy is improved by multilobar resection
AU - Barba, Carmen
AU - Rheims, Sylvain
AU - Minotti, Lorella
AU - Grisotto, Laura
AU - Chabardès, Stéphan
AU - Guenot, Marc
AU - Isnard, Jean
AU - Pellacani, Simona
AU - Hermier, Marc
AU - Ryvlin, Philippe
AU - Kahane, Philippe
N1 - Publisher Copyright: © 2022 International League Against Epilepsy.
PY - 2022
Y1 - 2022
N2 - Objective: Temporal plus epilepsy (TPE) represents a rare type of epilepsy characterized by a complex epileptogenic zone including the temporal lobe and the close neighboring structures. We investigated whether the complete resection of temporal plus epileptogenic zone as defined through stereoelectroencephalography (SEEG) might improve seizure outcome in 38 patients with TPE. Methods: Inclusion criteria were as follows: epilepsy surgery performed between January 1990 and December 2001, SEEG defining a temporal plus epileptogenic zone, unilobar temporal operations (“temporal lobe epilepsy [TLE] surgery”) or multilobar interventions including the temporal lobe (“TPE surgery”), magnetic resonance imaging either normal or showing signs of hippocampal sclerosis, and postoperative follow-up of at least 12 months. For each assessment of postoperative seizure outcome, at 1, 2, 5, and 10 years, we carried out descriptive analysis and classical tests of hypothesis, namely, Pearson χ2 test or Fisher exact test of independence on tables of frequency for each categorical variable of interest and Student t-test for each continuous variable of interest, when appropriate. Results: Twenty-one patients underwent TPE surgery and 17 underwent TLE surgery with a follow-up of 12.4 ± 8.16 years. In the multivariate models, there was a significant effect of the time from surgery on Engel Class IA versus IB–IV outcome, with a steadily worsening trend from 5-year follow-up onward. TPE surgery was associated with better results than TLE surgery. Significance: This study suggests that surgical outcome in patients with TPE can be improved by a tailored, multilobar resection and confirms that SEEG is mandatory when a TPE is suspected.
AB - Objective: Temporal plus epilepsy (TPE) represents a rare type of epilepsy characterized by a complex epileptogenic zone including the temporal lobe and the close neighboring structures. We investigated whether the complete resection of temporal plus epileptogenic zone as defined through stereoelectroencephalography (SEEG) might improve seizure outcome in 38 patients with TPE. Methods: Inclusion criteria were as follows: epilepsy surgery performed between January 1990 and December 2001, SEEG defining a temporal plus epileptogenic zone, unilobar temporal operations (“temporal lobe epilepsy [TLE] surgery”) or multilobar interventions including the temporal lobe (“TPE surgery”), magnetic resonance imaging either normal or showing signs of hippocampal sclerosis, and postoperative follow-up of at least 12 months. For each assessment of postoperative seizure outcome, at 1, 2, 5, and 10 years, we carried out descriptive analysis and classical tests of hypothesis, namely, Pearson χ2 test or Fisher exact test of independence on tables of frequency for each categorical variable of interest and Student t-test for each continuous variable of interest, when appropriate. Results: Twenty-one patients underwent TPE surgery and 17 underwent TLE surgery with a follow-up of 12.4 ± 8.16 years. In the multivariate models, there was a significant effect of the time from surgery on Engel Class IA versus IB–IV outcome, with a steadily worsening trend from 5-year follow-up onward. TPE surgery was associated with better results than TLE surgery. Significance: This study suggests that surgical outcome in patients with TPE can be improved by a tailored, multilobar resection and confirms that SEEG is mandatory when a TPE is suspected.
KW - epilepsy surgery
KW - long-term
KW - SEEG
KW - seizure outcome
KW - temporal plus
U2 - 10.1111/epi.17185
DO - 10.1111/epi.17185
M3 - Journal article
C2 - 35165888
AN - SCOPUS:85124596310
VL - 63
SP - 769
EP - 776
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 4
ER -
ID: 313778014