Pain & Central Nervous System Week via NewsEdge :

2008 MAY 12 - (NewsRx.com) -- Current study results from the report, 'Long-term outcome of extratemporal epilepsy surgery among 154 adult patients,' have been published (see also Epilepsy). "The goal of this study was to evaluate the long-term outcome of patients who underwent extratemporal epilepsy surgery and to assess preoperative prognostic factors associated with seizure outcome. This retrospective study included 154 consecutive adult patients who underwent epilepsy surgery at Bethel Epilepsy Centre, Bielefeld, Germany between 1991 and 2001," scientists in Bielefeld, Germany report.

"Seizure outcome was categorized based on the modified Engel classification. Survival statistics were calculated using Kaplan-Meier curves, life tables, and Cox regression models to evaluate the risk factors associated with outcomes. Sixty-one patients (39.6%) underwent frontal resections, 68 (44.1%) had posterior cortex resections, 15 (9.7%) multilobar resections, 6 (3.9%) parietal resections, and 4 (2.6%) occipital resections. The probability of an Engel Class I outcome for the overall patient group was 55.8% (95% confidence interval [CI] 52-58% at 0.5 years), 54.5% (95% CI 50-58%) at 1 year, and 51.1% (95% CI 48-54%) at 14 years. If a patient was in Class I at 2 years postoperatively, the probability of remaining in Class I for 14 years postoperatively was 88% (95% CI 78-98%). Factors predictive of poor long-term outcome after surgery were previous surgery (p=0.04), tonic-clonic seizures (p=0.02), and the presence of an auditory aura (p=0.03). Factors predictive of good long-term outcome were surgery within 5 years after onset (p=0.015) and preoperative invasive monitoring (p=0.002). Extratemporal epilepsy surgery is effective according to findings on long-term follow-up," wrote A.E. Elsharkawy and colleagues, Epilepsy Center.

The researchers concluded: "The outcome at the first 2-year follow-up visit is a reliable predictor of long-term Engel Class I postoperative outcome."

Elsharkawy and colleagues published their study in the Journal of Neurosurgery (Long-term outcome of extratemporal epilepsy surgery among 154 adult patients. Journal of Neurosurgery, 2008;108(4):676-86).

For more information, contact A.E. Elsharkawy, Bethel Epilepsy Centre, Dept. of Presurgical Evaluation, Bielefeld, Germany.

Publisher contact information for the Journal of Neurosurgery is: American Association Neurological Surgeons, University Virginia, 1224 West Main St., Ste. 450, Charlottesville, VA 22903, USA.

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