Abstracts

Rationale: The prevalence of epilepsy is higher in Latin America than in the developed countries. In our area at least 60% of patients remain undiagnosed or untreated. (PAHO / WHO, 2008). Although there are established guidelines that recommend the referral of the appropriate candidates for epilepsy surgery, underutilization of epilepsy surgery continues to be a problem (Flon et al, 2010; Haneef et al, 2010). In Latin America, only six countries have epilepsy surgery programs and the published results are comparable to those obtained in developed countries. There are few studies that report the outcome and complications of patients that undergo epilepsy surgery in Latin America. Methods: We performed a descriptive and retrospective study of 165 patients submitted to epilepsy surgery evaluation at the epilepsy clinic of National Institute of Neurology and Neurosurgery from 2006-2012. We included 95 patients who had surgery and whose records were complete and available for analysis. The main objectives were to describe medical and neurological complications in patients undergoing surgery for epilepsy by dividing them into minor and major complications. Secondary objectives were to describe the type of epilepsy and surgery who underwent patients and post-operative outcomes using the Engel scale. Results: Forty five (46.3%) were male. Age ranged from 18 to 60 years (mean 35.54 ± 9,765), with epilepsy onset at 9.33 ± 7.2 years and mean age at surgery 32 ± 9.95. Most patients (70/73%) had temporal lobe epilepsy, 35 (21,2%) had extratemporal epilepsy, 18 (10,9%) had Lennox-Gastaut syndrome and 8 (4,8%) other. The type of surgery performed corresponded to lobectomy in 70 (73,7%), 9 (5%) lesionectomies, 15 (8%) corpus callosotomies and placement of vagus nerve stimulator in one (1%). Seventy eight patients (82.2%) had no complications from the epilepsy surgery. Medical complications consisted in 2 (2,1%) had CSF fistula, one (1%) intracranial infection 1.1% (n = 1) and 4 (4.2%) extracranial infection. Minor neurological complications were cranial nerve deficits in 2 (2.1%), dysphasia in 1 (1.1%) and intracranial hematoma in one (1.1%). Regarding major neurological complications 2 (2.1%) had cranial nerve deficits or memory deficit and 2 (2.1%) had hemiparesis. Twenty five (26,4%) had visual field defects. Conclusions: Epilepsy surgery in our hospital proved to be a safe and effective option for the treatment of patients with drug resistant epilepsy. The success rate and complications is similar to that reported in other countries of the world. Most common neurological complications were visual field defects. Type of complication varied according to the type of surgery thus patients undergoing temporal lobectomy had more visual complications, memory impairment and cranial nerve deficits. Major neurological complications were found exclusively in patients with extratemporal epilepsy. None of the patients included in this study died from surgery or its complications.