Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood
There is a paucity of data on longitudinal seizure outcome of children undergoing epilepsy surgery. All children (n = 132) who underwent resective epilepsy surgery from January 1998 to December 2015 were identified. Relevant clinical, neurophysiological, imaging, surgical and seizure outcome data we...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986422000387 |
| _version_ | 1828517873190961152 |
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| author | Amy Ka Amir Taher Stephanie D'Souza Elizabeth H. Barnes Sachin Gupta Christopher Troedson Fiona Wade Olga Teo Russell C. Dale Chong Wong Andrew F. Bleasel Mark Dexter Kavitha Kothur Deepak Gill |
| author_facet | Amy Ka Amir Taher Stephanie D'Souza Elizabeth H. Barnes Sachin Gupta Christopher Troedson Fiona Wade Olga Teo Russell C. Dale Chong Wong Andrew F. Bleasel Mark Dexter Kavitha Kothur Deepak Gill |
| author_sort | Amy Ka |
| collection | DOAJ |
| description | There is a paucity of data on longitudinal seizure outcome of children undergoing epilepsy surgery. All children (n = 132) who underwent resective epilepsy surgery from January 1998 to December 2015 were identified. Relevant clinical, neurophysiological, imaging, surgical and seizure outcome data were extracted. Multivariable logistic regression analysis and Kaplan-Meier survival with Cox proportional hazard modelling were performed. The mean age at surgery was 7.8 years (range 0.2–17.9). 71% were seizure-free at a mean follow up of 5.3 ± 2.7 years. Of those who were seizure-free, 65 patients were able to completely wean off anti- seizure medications successfully. Using survival analysis, the probability of Engel Class I outcome at one year after surgery was 81% (95% confidence interval [CI] 87%–75%). This dropped to 73% at two years (95% CI 81%–65%), 58% at five years (95% CI 67.8%–48%), and 47% at ten years. Proportional hazard modelling showed that the presence of moderate to severe developmental disability (HR 6.5; p = 0.02) and lack of complete resection (HR 0.4; p = 0.02) maintain association as negative predictors of seizure-free outcome. Our study demonstrates favorable long-term seizure control following pediatric epilepsy surgery and highlights important predictors of seizure outcome guiding case selection and counseling of expectations prior to surgery. |
| first_indexed | 2024-12-11T18:47:26Z |
| format | Article |
| id | doaj.art-0e9988dcc0864d5ebbe0f1ed57ad5f5a |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-12-11T18:47:26Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-0e9988dcc0864d5ebbe0f1ed57ad5f5a2022-12-22T00:54:25ZengElsevierEpilepsy & Behavior Reports2589-98642022-01-0119100561Predictors of longitudinal seizure outcomes after epilepsy surgery in childhoodAmy Ka0Amir Taher1Stephanie D'Souza2Elizabeth H. Barnes3Sachin Gupta4Christopher Troedson5Fiona Wade6Olga Teo7Russell C. Dale8Chong Wong9Andrew F. Bleasel10Mark Dexter11Kavitha Kothur12Deepak Gill13TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, AustraliaUniversity of Sydney, The Children's Hospital at Westmead, Westmead, Sydney, NSW, AustraliaUniversity of Sydney, The Children's Hospital at Westmead, Westmead, Sydney, NSW, AustraliaNHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of SydneyTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, Australia; University of Sydney, The Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia; Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, AustraliaDepartment of Neurology, Westmead Hospital, Westmead, Sydney, AustraliaDepartment of Neurology, Westmead Hospital, Westmead, Sydney, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, Australia; Department of Neurology, Westmead Hospital, Westmead, Sydney, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, Australia; University of Sydney, The Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia; Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, AustraliaTY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, NSW, Australia; University of Sydney, The Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia; Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia; Corresponding author at: TY Nelson Department of Neurology, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.There is a paucity of data on longitudinal seizure outcome of children undergoing epilepsy surgery. All children (n = 132) who underwent resective epilepsy surgery from January 1998 to December 2015 were identified. Relevant clinical, neurophysiological, imaging, surgical and seizure outcome data were extracted. Multivariable logistic regression analysis and Kaplan-Meier survival with Cox proportional hazard modelling were performed. The mean age at surgery was 7.8 years (range 0.2–17.9). 71% were seizure-free at a mean follow up of 5.3 ± 2.7 years. Of those who were seizure-free, 65 patients were able to completely wean off anti- seizure medications successfully. Using survival analysis, the probability of Engel Class I outcome at one year after surgery was 81% (95% confidence interval [CI] 87%–75%). This dropped to 73% at two years (95% CI 81%–65%), 58% at five years (95% CI 67.8%–48%), and 47% at ten years. Proportional hazard modelling showed that the presence of moderate to severe developmental disability (HR 6.5; p = 0.02) and lack of complete resection (HR 0.4; p = 0.02) maintain association as negative predictors of seizure-free outcome. Our study demonstrates favorable long-term seizure control following pediatric epilepsy surgery and highlights important predictors of seizure outcome guiding case selection and counseling of expectations prior to surgery.http://www.sciencedirect.com/science/article/pii/S2589986422000387Focal cortical dysplasiaEpilepsyEpilepsy surgeryTumours |
| spellingShingle | Amy Ka Amir Taher Stephanie D'Souza Elizabeth H. Barnes Sachin Gupta Christopher Troedson Fiona Wade Olga Teo Russell C. Dale Chong Wong Andrew F. Bleasel Mark Dexter Kavitha Kothur Deepak Gill Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood Epilepsy & Behavior Reports Focal cortical dysplasia Epilepsy Epilepsy surgery Tumours |
| title | Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| title_full | Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| title_fullStr | Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| title_full_unstemmed | Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| title_short | Predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| title_sort | predictors of longitudinal seizure outcomes after epilepsy surgery in childhood |
| topic | Focal cortical dysplasia Epilepsy Epilepsy surgery Tumours |
| url | http://www.sciencedirect.com/science/article/pii/S2589986422000387 |
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