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Neurol India. 2011 Jan-Feb;59(1):30-6. doi: 10.4103/0028-3886.76854.

Outcome of epilepsy surgery in children after evaluation with non-invasive protocol.

Author information

  • 1Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India. sita_js@hotmail.com

Abstract

OBJECTIVE:

To assess outcome of epilepsy surgery in children with medically refractory partial epilepsy evaluated with non-invasive protocol and to determine the predictors of outcome.

PATIENTS AND METHODS:

Retrospective analysis of presurgical, surgical, and postsurgical data was performed in 87 children who had at least 1 year post surgery follow-up. Outcome was assessed according to Engel's outcome classification. Stepwise regression followed by logistic regression analysis was employed in data analysis.

RESULTS:

Mean follow-up was 32 (12-58) months and 44 (50.6%) were males. The age of onset of epilepsy was below the age of 2 years in 24 (30.8%). Resective surgery was done in 78 children. The commonest surgery performed was a temporal resection (88.9%) in adolescents and an extra-temporal resection ( 60.6%) in children. The commonest pathology was hippocampal sclerosis (HS) in adolescents and developmental, tumoral lesions, and gliosis in children. At last follow-up, 50 (64.1%) were seizure free and Engel's favourable outcome was noted in 59 (75.6%). After stepwise regression analysis, variables found to be significant (P < 0.05) and predicting a favourable outcome were lesion on MRI, normal IQ, and partial seizures without secondary generalization. Bilateral spikes on interictal EEG and acute postoperative seizures were predictors of poor outcome. A regression model was developed; the sensitivity, specificity, accuracy, and area under ROC curve were 82%, 91%, 88.5%, and 0.97%, respectively.

CONCLUSION:

Favourable outcome after epilepsy surgery can be obtained in children with temporal lobe epilepsy with HS and lesion-related epilepsies in developing countries with limited resources, after evaluation with a non-invasive protocol.

PMID:
21339655
[PubMed - indexed for MEDLINE]
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