Factors associated with seizure recurrence in drug-resistant temporal epilepsy surgery

Abstract

Introduction: Temporal lobe epilepsy is the most common form of focal epilepsy, 30% of cases are drug-resistant. Surgery in these patients is cost-effective superior to medical treatment. Objective: To identify variables of the pre-surgical, trans-surgical and post-surgical phase related to seizure recurrence, one year after surgery. Methods: A descriptive study was carried out with a series of 24 cases, evaluated and surgically intervened with drug-resistant temporal lobe epilepsy; all patients underwent a detailed clinical history, video telemetry, magnetic resonance imaging and neuropsychology. Receptive techniques and pre- and post-resection electrocorticography were used to adjust the resection site. Patients were evaluated with the Engel scale one year after surgery. Fisher's exact test was used to determine the association between the variables. The value of p≤ 0.05 was significant. Results: Post-surgical follow-up was one year. Seizure freedom (Engel I) was obtained in 79.2% of cases. The incomplete resection of the epileptogenic zone (p= 0.028), the presence of acute postoperative seizures (p= 0.036) and seizure six months after surgery (p= 0.002), was statistically associated with seizure recurrence. Conclusions: One year after surgery, most of the operated patients still seizure free. The incomplete resection of the epileptogenic zone, the acute postoperative seizures and the presence of seizure six months after surgery was statistically associated with seizure recurrence.

Keywords

• cirugía de epilepsia del lóbulo temporal
• pronóstico posquirúrgico
• predictores.