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CURRENT ISSUEJOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Quarterly

ISSN 0390-5616

Online ISSN 1827-1855

 

Journal of Neurosurgical Sciences 2015 Jan 20

Prognostic factors for temporal lobe epilepsy surgery in a tertiary center

Rocha da Cruz Adry R. A. 1, Crociati Meguins L. 1, de Santana de Tomi R. 2, Pongeluppi R. I. 2, da Silva Júnior S. C. 1, de Araújo Filho G. M. 3, Neves Marques L. H. 4

1 Serviço de Neurocirurgia, Departamento de Ciências Neurológicas, Hospital de Base de São José do Rio Preto – Faculdade de Medicina de São José do Rio Preto;
2 Hospital de Base de São José do Rio Preto – Faculdade de Medicina de São José do Rio Preto;
3 Serviço de Psiquiatria, Departamento de Psiquiatria e Psicologia Médica, Hospital de Base de São José do Rio Preto, Faculdade de Medicina de São José do Rio Preto;
4 Serviço de Neurologia, Departamento de Ciências Neurológicas, Hospital de Base de São José do Rio Preto, Faculdade de Medicina de São José do Rio Preto

BACKGROUND: Temporal lobe epilepsy (TLE) represents the most common type of partial epilepsy. Early age of onset, a history of febrile convulsions, epileptiform discharges on EEG, duration of epilepsy, number of generalized seizures and severity of psychiatric disorders are possible prognostic factors in patients with mesial temporal sclerosis.
OBJETIVE: The aim of this study is to review the findings of clinical research, semiotic, psychological, electrophysiological and neuroradiological, relate their findings with the prognosis of patients with TLE who underwent anteromedial temporal lobectomy (ATL).
METHODS: Of 1214 patients evaluated for surgery in the epilepsy Center of Faculdade de Medicina de São Jose do Rio Preto (FAMERP), a tertiary Brazilian epilepsy center, 459 underwent ATL for TLE. Exams and clinical data was analyzed and compared with Engel classification for outcome.
RESULTS: Of all the items analyzed, the MRI showed a greater influence on the outcome of patients and for clinical evaluation and pathological antecedents, age at surgery, the epilepsy duration, seizure frequency, mesial temporal sclerosis, dysplasia, perinatal insults, vascular insults, a family history of epilepsy, febrile seizures, neuropsychological abnormalities and presence of generalized tonic clonic seizure has a statistical significance.
CONCLUSION: In order to identify the most appropriate candidates for ATL, is very important to consider the prognostic factors associated with favorable for counseling patients in daily practice.

language: English


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