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2020, Number 3

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Rev Cubana Neurol Neurocir 2020; 10 (3)

Prognostic factors and seizure recurrence after temporary and extra temporal epilepsy surgery

Santos SA, Morales CLM, Dearriba RMU

Language: Spanish
References: 49
Page: 1-22
PDF size: 356.57 Kb.


ABSTRACT

Objective: To describe the factors of good postoperative prognosis and recurrence of seizures after surgery for temporary and extra temporal epilepsy.
Acquisition of evidence: A review of the literature was carried out in BVS, PUBMED and COCHRANE databases. Forty articles published from 2015 to 2020 were selected, in their full version, in Spanish, English and Portuguese languages. The following keywords were used: “Epilepsy surgery” AND “seizure outcome”, “Predictors of seizure recurrence”, “Prognostic factors of postoperative seizure outcome”.
Results: In the reviewed articles, a total of 31,024 participants (children and adults) were evaluated. The seizures free range after surgery was from 14% to 92%, depending on the study and the population. The most identified predictors of good prognosis were duration of epilepsy <10 years, positive magnetic resonance imaging, diagnosis of hippocampal sclerosis or low-grade tumor, and complete resection. In non-lesional cases, the delimitation of the epileptogenic zone was observed, locating functional magnetic resonance images and consistent with the rest of the evaluation. The most frequently found predictors of recurrence were preoperative invasive monitoring, incomplete resection, and isolated cortical dysplasia.
Conclusions: The short duration of epilepsy, positive magnetic resonance imaging and complete resection of the epileptogenic area were the most observed good prognostic factors; and in non-lesional cases, the correct delimitation of the epileptogenic zone was the most frequent. The most common modifiable factor was the duration of epilepsy before the patient was admitted for surgery.


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