FREQUENCY OF EPILEPSY SURGERY IN A POPULATION WITH MEDICALLY REFRACTORY PARTIAL EPILEPSY
Abstract number :
2.461
Submission category :
Year :
2003
Submission ID :
1793
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Mihaela Mihaescu, Linda M. Selwa, Daniela N. Minecan, Jonathan C. Edwards, Ekrem Kutluay, Barbara Schauble, Ahmad Beydoun Clinical Neurophysiology, University of Michigan, Ann Arbor, MI
To assess what proportion of patients with localization related epilepsies admitted for CCTV/EEG are good surgical candidates. It is frequently stated that only a quarter to one third of patients with refractory partial-onset seizures will prove to be good surgical candidates. However, there is no published data to support this statement.
We retrospectively reviewed all long-term video-EEG monitoring studies performed at the University of Michigan over a consecutive 12-month period. We selected patients with presumed medically refractory localization-related epilepsies and evaluated the percentage that subsequently underwent epilepsy surgery. In addition, we determined the grounds for rejection of the surgery in the remaining group of patients.
145 patients underwent long-term video-EEG monitoring during the study period. Of those, 60 patients (41 %) were diagnosed with localization-related epilepsies and formed the basis of this study. The reasons for excluding the other patients were as follows: 20 (13.8 %) patients did not experience their habitual events during the monitoring period, 61 (41.7 %) were diagnosed with non-epileptic events and 4 (2.75 %) patients were diagnosed with generalized epilepsies. Twenty-six of the 60 patients (43%) underwent epilepsy surgery. Of those who did not have surgery, 22 (65%) patients were considered to be non-surgical candidates because of bilateral temporal independent ictal onsets (8 patients) or non-localizing ictal onsets (14 patients). Twelve (35%) patients, considered eligible for epilepsy surgery did not pursue it for various reasons: 2 patients refused invasive monitoring, 2 patients eventually achieved good seizure control on antiepileptic drugs, 1 patient expired and 7 patients were lost for follow-up.
The majority of patients with medically refractory localization related epilepsies that admitted for pre-surgical CCTV/EEG monitoring turn out to be good surgical candidates. The higher percentage could be related to a selection bias due to a screening prior to referral for CCTV/EEG monitoring.