Open Access
CC BY-NC-ND 4.0 · International Journal of Epilepsy 2023; 09(01/02): A1-A40
DOI: 10.1055/s-0044-1791395
Oral Abstracts

OP-11 Long-Term Functional Outcomes of Epilepsy Surgery in Pediatric Structural Drug-Resistant Epilepsy

Authors

  • Shridhar Joshi

    1   CMC Vellore Hospital, Vellore, Tamil Nadu, India

  • Maya Thomas

    1   CMC Vellore Hospital, Vellore, Tamil Nadu, India

  • Sangeetha Yoganathan

    1   CMC Vellore Hospital, Vellore, Tamil Nadu, India

  • Krishna Prabhu

    1   CMC Vellore Hospital, Vellore, Tamil Nadu, India
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Background: Seizure freedom, decreased burden of antiseizure medications and improvement in neurodevelopmental, cognitive, and motor decline can be achieved via epilepsy surgery in patients with structural drug-resistant epilepsy (DRE).

Aims and Objectives: To describe clinical-etiologic, seizure freedom and the long-term functional outcomes (at least 5-year follow-up) in children ≤18 years who underwent epilepsy surgery between January 2004 and December 2016.

Methods: Preoperative clinical, electroencephalography (EEG), imaging, and surgical data were collected from retrospective chart review. A structured questionnaire was used to assess postoperative functional outcomes. International League Against Epilepsy (ILAE) epilepsy surgery outcome classification was used for postoperative seizure outcome.

Results: Seventy-five children (male:female 1.2:1) had onset of epilepsy and underwent epilepsy surgery at median age of 30 months and 9.6 years respectively. Perinatal insults (hypoglycemia, asphyxia, stroke; n = 18,21.3%) followed by malformations of cortical development (n = 15, 20%) constituted major etiologies. Surgical procedures performed were: Peri-insular hemispherotomy (n = 35, 46.6%), anterior temporal lobectomy with amygdalohippocampectomy (n = 23,30.6%), posterior quadrantectomy (n = 9, 12%), lesionectomy/lobectomy (n = 7, 9.3%), and cyst fenestration (n = 1, 1.3%). Fifty-five (73.3%) patients were either completely seizure-free or had only auras up to 3 seizure days per year. Sixty-four (87.7%) patients walked independently. Nine (12%) patients developed new visual symptoms postoperatively. Fifty-six (76.7%) and 43 (58.89%) children had satisfactory spoken language skills and reading skills, respectively. Significant behavioral problems were reported in 16 patients (21.92%). Two patients succumbed due to persistent seizures and probable aspiration pneumonitis at home.

Conclusion: Epilepsy surgery achieves long-term seizure freedom and functional outcomes in structural DRE.



Publikationsverlauf

Artikel online veröffentlicht:
12. September 2024

© 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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