Predictors of prognosis in patients with temporal lobe epilepsy after anterior temporal lobectomy

Sun,Zhenxing; Zuo,Huancong; Yuan,Dan; Sun,Yaxing; Zhang,Kai; Cui,Zhiqiang; Wang,Jin

doi:10.3892/etm.2015.2753

Predictors of prognosis in patients with temporal lobe epilepsy after anterior temporal lobectomy

Authors:
- Zhenxing Sun
- Huancong Zuo
- Dan Yuan
- Yaxing Sun
- Kai Zhang
- Zhiqiang Cui
- Jin Wang
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Affiliations: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China, Department of Neurology, The Luhe Teaching Hospital, Capital Medical University, Beijing 101149, P.R. China, Department of Psychiatry, The Second Municipal Hospital of Zaozhuang, Zaozhuang, Shandong 277100, P.R. China, Department of Neurosurgery, Tiantan Hospital, Capital Medical University, Beijing 101149, P.R. China, Department of Neurosurgery, Changgung Hospital, Tsinghua University Medical Center, Beijing 100084, P.R. China
Published online on: September 18, 2015 https://doi.org/10.3892/etm.2015.2753
Pages: 1896-1902

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Abstract

The aim of this study was to evaluate the predictive value of prognostic factors for the surgical outcome of patients with mesial temporal lobe epilepsy (MTLE) using Engel seizure classification. The clinical data of 121 patients with MTLE who underwent anterior temporal lobectomy (ATL) and received a 1‑year minimum follow‑up were collected between January 2005 and December 2008. Patients were divided into seizure and seizure‑free groups according to the Engel seizure classification. Univariate analysis and multivariate logistic regression analysis were used to analyze the potential predictive and prognostic factors, including medical history, clinical features of seizures, magnetic resonance imaging (MRI) and video‑electroencephalogram (EEG) monitoring results. Univariate analysis indicated no statistically significant differences in gender, age at seizure onset, age at surgery, history of traumatic brain injury, perinatal anoxia, intracranial infection, family history of seizure, auras or site of surgery between the two groups; however, significant differences were detected in pre‑surgical seizure duration, history of febrile seizures, seizure types, MRI and video‑EEG results. Multivariate logistic regression analysis demonstrated that a pre‑surgical seizure duration of <10 years, history of positive febrile seizures, simple complex partial seizure, positive MRI results and unilateral local video‑EEG spikes may be considered as predictors of a good prognosis. These results indicate that remission may be achieved in patients with MTLE via the collection of accurate clinical information and adequate pre-surgical evaluation.

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