Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy
Aim. To identify predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy in a multivariate model.Materials and methods. Aretrospective study included 69 patients with drug-resistant temporal lobe epilepsy who underwent microsurgical anterior temporal lobectomy. The stu...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | Russian |
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Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
2023-01-01
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| Series: | Сеченовский вестник |
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| Online Access: | https://www.sechenovmedj.com/jour/article/view/872 |
| _version_ | 1797873590050226176 |
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| author | I. S. Shelyagin P. O. Akimova S. Zh. Stefanov R. A. Sufianov |
| author_facet | I. S. Shelyagin P. O. Akimova S. Zh. Stefanov R. A. Sufianov |
| author_sort | I. S. Shelyagin |
| collection | DOAJ |
| description | Aim. To identify predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy in a multivariate model.Materials and methods. Aretrospective study included 69 patients with drug-resistant temporal lobe epilepsy who underwent microsurgical anterior temporal lobectomy. The study included 31 (45%) men and 38 (55%) women. The median age was 28 (21; 36). Surgical treatment outcomes were assessed at 6, 12, 36, and 60 months after surgical intervention according to the Engel Epilepsy Surgery Outcome Scale. Logistic regression equations were calculated, a ROC curve was constructed, and odds ratio (OR) with 95% confidence interval (CI), sensitivity, specificity, area under the ROC curve (AUC) were calculated.Results. In all assessed time periods, 88.3–93.0% of patients had outcomes consistent with Engel classes I and II. The distribution of patients by outcome classes did not change statistically significantly over the entire follow-up period. There were the following predictors of high efficacy of surgical treatment at 6 months after surgery: relatively shorter duration of active disease course (OR 0.719, 95%, CI: 0.437–0.966, p < 0.05), absence of status epilepticus (OR 0.048, 95% CI: 0.002–0.472, p < 0.05), absence of subdominant foci of irritative activity (OR 0.123, 95% CI: 0.012–0.845, p < 0.01), presence of mesial temporal sclerosis (OR 1008, 95% CI: 21.59–1310851, p < 0.01), a relatively longer resection margin on the temporal lobe (OR 637.32, 95% CI: 5.43–1960062, p < 0.05), lateralization of epileptogenic zone in subdominant hemisphere (OR 0.103, 95% CI 0.004–0.937, p = 0.0532). AUC was 0.957 (0.917–0.997), p < 0.0001; sensitivity 87.5%, and specificity 82.8%.Conclusion. Independent predictors of the efficacy of microsurgical anterior temporal lobectomy in patients with drug-resistant temporal lobe epilepsy are the following: shorter duration of active disease course, absence of status epilepticus in the history, absence of subdominant foci, presence of mesial temporal sclerosis, a relatively longer resection margin on the temporal lobe, and lateralization of the epileptogenic zone in the temporal lobe of the subdominant hemisphere. |
| first_indexed | 2024-04-10T01:18:40Z |
| format | Article |
| id | doaj.art-927a1ff87b8446249230ac5a89e201b9 |
| institution | Directory Open Access Journal |
| issn | 2218-7332 2658-3348 |
| language | Russian |
| last_indexed | 2024-04-10T01:18:40Z |
| publishDate | 2023-01-01 |
| publisher | Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) |
| record_format | Article |
| series | Сеченовский вестник |
| spelling | doaj.art-927a1ff87b8446249230ac5a89e201b92023-03-13T09:51:37ZrusFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Сеченовский вестник2218-73322658-33482023-01-01133243310.47093/2218-7332.2022.13.3.24-33554Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsyI. S. Shelyagin0P. O. Akimova1S. Zh. Stefanov2R. A. Sufianov3Tyumen State Medical University; Federal Centre of NeurosurgeryFederal Centre of NeurosurgeryFederal Centre of NeurosurgerySechenov First Moscow State Medical University (Sechenov University)Aim. To identify predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy in a multivariate model.Materials and methods. Aretrospective study included 69 patients with drug-resistant temporal lobe epilepsy who underwent microsurgical anterior temporal lobectomy. The study included 31 (45%) men and 38 (55%) women. The median age was 28 (21; 36). Surgical treatment outcomes were assessed at 6, 12, 36, and 60 months after surgical intervention according to the Engel Epilepsy Surgery Outcome Scale. Logistic regression equations were calculated, a ROC curve was constructed, and odds ratio (OR) with 95% confidence interval (CI), sensitivity, specificity, area under the ROC curve (AUC) were calculated.Results. In all assessed time periods, 88.3–93.0% of patients had outcomes consistent with Engel classes I and II. The distribution of patients by outcome classes did not change statistically significantly over the entire follow-up period. There were the following predictors of high efficacy of surgical treatment at 6 months after surgery: relatively shorter duration of active disease course (OR 0.719, 95%, CI: 0.437–0.966, p < 0.05), absence of status epilepticus (OR 0.048, 95% CI: 0.002–0.472, p < 0.05), absence of subdominant foci of irritative activity (OR 0.123, 95% CI: 0.012–0.845, p < 0.01), presence of mesial temporal sclerosis (OR 1008, 95% CI: 21.59–1310851, p < 0.01), a relatively longer resection margin on the temporal lobe (OR 637.32, 95% CI: 5.43–1960062, p < 0.05), lateralization of epileptogenic zone in subdominant hemisphere (OR 0.103, 95% CI 0.004–0.937, p = 0.0532). AUC was 0.957 (0.917–0.997), p < 0.0001; sensitivity 87.5%, and specificity 82.8%.Conclusion. Independent predictors of the efficacy of microsurgical anterior temporal lobectomy in patients with drug-resistant temporal lobe epilepsy are the following: shorter duration of active disease course, absence of status epilepticus in the history, absence of subdominant foci, presence of mesial temporal sclerosis, a relatively longer resection margin on the temporal lobe, and lateralization of the epileptogenic zone in the temporal lobe of the subdominant hemisphere.https://www.sechenovmedj.com/jour/article/view/872temporal lobectomyvideo-eeg monitoringmesial temporal sclerosismultivariate analysislogistic regressionroc curve |
| spellingShingle | I. S. Shelyagin P. O. Akimova S. Zh. Stefanov R. A. Sufianov Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy Сеченовский вестник temporal lobectomy video-eeg monitoring mesial temporal sclerosis multivariate analysis logistic regression roc curve |
| title | Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy |
| title_full | Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy |
| title_fullStr | Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy |
| title_full_unstemmed | Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy |
| title_short | Predictors of surgical outcomes in patients with drug-resistant temporal lobe epilepsy |
| title_sort | predictors of surgical outcomes in patients with drug resistant temporal lobe epilepsy |
| topic | temporal lobectomy video-eeg monitoring mesial temporal sclerosis multivariate analysis logistic regression roc curve |
| url | https://www.sechenovmedj.com/jour/article/view/872 |
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