Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome
Successful surgery for drug-resistant pediatric epilepsy can facilitate motor and cognitive development and improve quality of life by resolution or reduction of epileptic seizures. Therefore, surgery should be considered early in the disease course. However, in some cases, the estimated surgical ou...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Neurosurgical Society
2023-05-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/5/63_2022-0300/_pdf/-char/en |
| _version_ | 1827932292034592768 |
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| author | Satoru OSHINO Naoki TANI Hui KHOO Kuriko KAGITANI-SHIMONO Shin NABATAME Koji TOMINAGA Takufumi YANAGISAWA Masayuki HIRATA Haruhiko KISHIMA |
| author_facet | Satoru OSHINO Naoki TANI Hui KHOO Kuriko KAGITANI-SHIMONO Shin NABATAME Koji TOMINAGA Takufumi YANAGISAWA Masayuki HIRATA Haruhiko KISHIMA |
| author_sort | Satoru OSHINO |
| collection | DOAJ |
| description | Successful surgery for drug-resistant pediatric epilepsy can facilitate motor and cognitive development and improve quality of life by resolution or reduction of epileptic seizures. Therefore, surgery should be considered early in the disease course. However, in some cases, the estimated surgical outcomes are not achieved, and additional surgical treatments are considered. In this study, we investigated the clinical factors related with such unsatisfactory outcomes.
We reviewed the clinical data of 92 patients who underwent 112 surgical procedures (69 resection and 53 palliation procedures). Surgical outcomes were assessed according to the postoperative disease status, which was classified as good, controlled, and poor. The following clinical factors were analyzed in relation to surgical outcome: sex, age at onset, etiology (malformation of cortical development, tumor, temporal lobe epilepsy, scar, inflammation, and non-lesional epilepsy), presence of genetic cause, and history of developmental epileptic encephalopathy. At a median of 59 (30-81.25) months after the initial surgery, the disease status was good in 38 (41%), controlled in 39 (42%), and poor in 15 (16%) patients. Among the evaluated factors, etiology exhibited the strongest correlation with surgical outcomes. Tumor-induced and temporal lobe epilepsy were correlated with good, whereas malformation of cortical development, early seizure onset, and presence of genetic cause were correlated with poor disease status. Although epilepsy surgery for the patients who present with the latter factors is challenging, these patients demonstrate a greater need for surgical treatment. Hence, development of more effective surgical options is warranted, including palliative procedures. |
| first_indexed | 2024-03-13T07:06:30Z |
| format | Article |
| id | doaj.art-5c3f71bc4d4b4c2e8b675485d03231ad |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-13T07:06:30Z |
| publishDate | 2023-05-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-5c3f71bc4d4b4c2e8b675485d03231ad2023-06-06T08:42:06ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-05-0163517317810.2176/jns-nmc.2022-03002022-0300Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical OutcomeSatoru OSHINO0Naoki TANI1Hui KHOO2Kuriko KAGITANI-SHIMONO3Shin NABATAME4Koji TOMINAGA5Takufumi YANAGISAWA6Masayuki HIRATA7Haruhiko KISHIMA8Epilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalEpilepsy Center, Osaka University HospitalSuccessful surgery for drug-resistant pediatric epilepsy can facilitate motor and cognitive development and improve quality of life by resolution or reduction of epileptic seizures. Therefore, surgery should be considered early in the disease course. However, in some cases, the estimated surgical outcomes are not achieved, and additional surgical treatments are considered. In this study, we investigated the clinical factors related with such unsatisfactory outcomes. We reviewed the clinical data of 92 patients who underwent 112 surgical procedures (69 resection and 53 palliation procedures). Surgical outcomes were assessed according to the postoperative disease status, which was classified as good, controlled, and poor. The following clinical factors were analyzed in relation to surgical outcome: sex, age at onset, etiology (malformation of cortical development, tumor, temporal lobe epilepsy, scar, inflammation, and non-lesional epilepsy), presence of genetic cause, and history of developmental epileptic encephalopathy. At a median of 59 (30-81.25) months after the initial surgery, the disease status was good in 38 (41%), controlled in 39 (42%), and poor in 15 (16%) patients. Among the evaluated factors, etiology exhibited the strongest correlation with surgical outcomes. Tumor-induced and temporal lobe epilepsy were correlated with good, whereas malformation of cortical development, early seizure onset, and presence of genetic cause were correlated with poor disease status. Although epilepsy surgery for the patients who present with the latter factors is challenging, these patients demonstrate a greater need for surgical treatment. Hence, development of more effective surgical options is warranted, including palliative procedures.https://www.jstage.jst.go.jp/article/nmc/63/5/63_2022-0300/_pdf/-char/enepilepsy surgerypediatriclong-term outcome |
| spellingShingle | Satoru OSHINO Naoki TANI Hui KHOO Kuriko KAGITANI-SHIMONO Shin NABATAME Koji TOMINAGA Takufumi YANAGISAWA Masayuki HIRATA Haruhiko KISHIMA Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome Neurologia Medico-Chirurgica epilepsy surgery pediatric long-term outcome |
| title | Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome |
| title_full | Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome |
| title_fullStr | Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome |
| title_full_unstemmed | Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome |
| title_short | Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome |
| title_sort | clinical factors related to outcomes in pediatric epilepsy surgery insight into predictors of poor surgical outcome |
| topic | epilepsy surgery pediatric long-term outcome |
| url | https://www.jstage.jst.go.jp/article/nmc/63/5/63_2022-0300/_pdf/-char/en |
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