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Prognostic Role of Functional Neuroimaging after Multilobar Resection in Patients with Localization-Related Epilepsy.

Cho EB, Joo EY, Seo DW, Hong SC, Hong SB - PLoS ONE (2015)

Bottom Line: Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study.After 1 year, 56 patients (62.2%) became Engel class I and at the last follow-up, 47 patients (52.2%) remained seizure-free.Both localized PET and ictal-interictal SPECT subtraction co-registered to MR (SISCOM) predicted good surgical outcomes in the last follow-up (69.2%, Engel I).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience center, Samsung Medical Center, Seoul, South Korea.

ABSTRACT
To investigate the usage of functional neuroimaging as a prognostic tool for seizure recurrence and long-term outcomes in patients with multilobar resection, we recruited 90 patients who received multilobar resections between 1995 and 2013 with at least 1-year follow-up (mean 8.0 years). All patients were monitored using intracranial electroencephalography (EEG) after pre-surgical evaluation. Clinical data (demographics, electrophysiology, and neuroimaging) were reviewed retrospectively. Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study. After 1 year, 56 patients (62.2%) became Engel class I and at the last follow-up, 47 patients (52.2%) remained seizure-free. Furthermore, non-localized 18F-fluorodeoxyglucose positron emission tomography (PET), identifying hypometabolic areas not concordant with ictal onset zones, significantly correlated with seizure recurrence after 1 year. Non-lesional magnetic resonance imaging (MRI) and left-sided resection correlated with poor outcomes. In the last follow-up, non-localized PET and left-sided resection significantly correlated with seizure recurrence. Both localized PET and ictal-interictal SPECT subtraction co-registered to MR (SISCOM) predicted good surgical outcomes in the last follow-up (69.2%, Engel I). This study suggests that PET and SISCOM may predict postoperative outcomes for patients after multilobar epilepsy and shows comparable long-term surgical outcomes after multilobar resection.

No MeSH data available.


Related in: MedlinePlus

A Kaplan-Meier plot of time to the first seizure.Of 90 patients who underwent multilobar epilepsy surgery, 50 had a recurrence of seizures. 72% (n = 65) of patients were seizure-free at 6 months, 60% (n = 54) at 1 year, and 40% (n = 35) at 5 years.
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pone.0136565.g001: A Kaplan-Meier plot of time to the first seizure.Of 90 patients who underwent multilobar epilepsy surgery, 50 had a recurrence of seizures. 72% (n = 65) of patients were seizure-free at 6 months, 60% (n = 54) at 1 year, and 40% (n = 35) at 5 years.

Mentions: A Kaplan-Meier plot of time to the first seizure after surgery revealed 72% (n = 65, 95% CI 63–82) of patients were seizure-free at 6 months, 60% (n = 54, 95% CI 50–70) at 1 year, and 40% (n = 35, 95% CI 28–52) at 5 years (Fig 1). Early seizures occurred within 6 months for 25 patients (50%). Another 25 patients (50%) showed seizure recurrence 6 months after surgery. However, the final outcomes of patients with early seizures were not different from patients with late seizure recurrence. In the last follow-up, the number of patients with early seizures was four for Engel I, 10 for Engel II, one for Engel III, and 10 for Engel IV. Similarly, the number of patients with late seizures was three for Engel I, nine for Engel II, four for Engel III, and nine for Engel IV.


Prognostic Role of Functional Neuroimaging after Multilobar Resection in Patients with Localization-Related Epilepsy.

Cho EB, Joo EY, Seo DW, Hong SC, Hong SB - PLoS ONE (2015)

A Kaplan-Meier plot of time to the first seizure.Of 90 patients who underwent multilobar epilepsy surgery, 50 had a recurrence of seizures. 72% (n = 65) of patients were seizure-free at 6 months, 60% (n = 54) at 1 year, and 40% (n = 35) at 5 years.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4549147&req=5

pone.0136565.g001: A Kaplan-Meier plot of time to the first seizure.Of 90 patients who underwent multilobar epilepsy surgery, 50 had a recurrence of seizures. 72% (n = 65) of patients were seizure-free at 6 months, 60% (n = 54) at 1 year, and 40% (n = 35) at 5 years.
Mentions: A Kaplan-Meier plot of time to the first seizure after surgery revealed 72% (n = 65, 95% CI 63–82) of patients were seizure-free at 6 months, 60% (n = 54, 95% CI 50–70) at 1 year, and 40% (n = 35, 95% CI 28–52) at 5 years (Fig 1). Early seizures occurred within 6 months for 25 patients (50%). Another 25 patients (50%) showed seizure recurrence 6 months after surgery. However, the final outcomes of patients with early seizures were not different from patients with late seizure recurrence. In the last follow-up, the number of patients with early seizures was four for Engel I, 10 for Engel II, one for Engel III, and 10 for Engel IV. Similarly, the number of patients with late seizures was three for Engel I, nine for Engel II, four for Engel III, and nine for Engel IV.

Bottom Line: Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study.After 1 year, 56 patients (62.2%) became Engel class I and at the last follow-up, 47 patients (52.2%) remained seizure-free.Both localized PET and ictal-interictal SPECT subtraction co-registered to MR (SISCOM) predicted good surgical outcomes in the last follow-up (69.2%, Engel I).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience center, Samsung Medical Center, Seoul, South Korea.

ABSTRACT
To investigate the usage of functional neuroimaging as a prognostic tool for seizure recurrence and long-term outcomes in patients with multilobar resection, we recruited 90 patients who received multilobar resections between 1995 and 2013 with at least 1-year follow-up (mean 8.0 years). All patients were monitored using intracranial electroencephalography (EEG) after pre-surgical evaluation. Clinical data (demographics, electrophysiology, and neuroimaging) were reviewed retrospectively. Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study. After 1 year, 56 patients (62.2%) became Engel class I and at the last follow-up, 47 patients (52.2%) remained seizure-free. Furthermore, non-localized 18F-fluorodeoxyglucose positron emission tomography (PET), identifying hypometabolic areas not concordant with ictal onset zones, significantly correlated with seizure recurrence after 1 year. Non-lesional magnetic resonance imaging (MRI) and left-sided resection correlated with poor outcomes. In the last follow-up, non-localized PET and left-sided resection significantly correlated with seizure recurrence. Both localized PET and ictal-interictal SPECT subtraction co-registered to MR (SISCOM) predicted good surgical outcomes in the last follow-up (69.2%, Engel I). This study suggests that PET and SISCOM may predict postoperative outcomes for patients after multilobar epilepsy and shows comparable long-term surgical outcomes after multilobar resection.

No MeSH data available.


Related in: MedlinePlus