Long-Term Seizure Outcome Following Resective Surgery for Epilepsy: To be or Not to be Completely Cured?
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概要
- 論文の詳細を見る
Surgical intervention is expected to improve the quality of life in patients with intractable epilepsy by providing adequate seizure control. Although many previous studies showed various rates of seizure freedom, definite conclusions have not yet been made regarding outcomes. In order to clarify the long-term postoperative outcome for a period up to 10 years, a retrospective review of our patients was performed longitudinally by using the survival analysis method. The postoperative state of epilepsy in 76 patients who underwent resection surgery was assessed based on Engel's criteria. In addition, Kaplan-Meier survival analysis was used to calculate the probability of seizure freedom. In this patient group, abnormal lesion were detected by MRI in 70 out of 76 cases, and the ictal onset zone was finally identified within temporal lobe in 51 cases. The most favorable outcome, defined as Engel Class Ia, was observed in 26 (37%), 24 (40%), and 18 (41%) cases at 2, 5, and 10 years after surgery, respectively. The Kaplan-Meier survival curve in the overall group estimated the probability of seizure freedom as 75% (95% confidence interval [CI] 70–80%), 67% (62–72%), and 51% (45–57%) at 2, 5, and 10 years follow up, respectively. Half of all seizure recurrences occurred within the first 2 postoperative years. In this study, we showed that long-term favorable outcome of seizure control following resection surgery can be achieved in more than half of the patients.
著者
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Kunieda Takeharu
Department Of Neurosurgery Kobe City General Hospital
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Takahashi Jun
Department Of Cardiology Iwate Prefectural Central Hospital
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Fukuyama Hidenao
Department Of Brain Pathophysiology Faculty Of Medicine Kyoto University
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Mikuni Nobuhiro
Department Of Neurosurgery Kyoto University Graduate School Of Medicine
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Kikuchi Takayuki
Department Of Chemistry Graduate School Of Science Osaka University
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Miyamoto Susumu
Department Of Internal Medicine Himi City Hospital
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Ikeda Akio
Department Of Applied Chemistry & Biotechnology Faculty Of Engineering Yamanashi University
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Matsumoto Riki
Department Of Neurology Kyoto University Graduate School Of Medicine
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FUKUYAMA Hidenao
Department of Human Brain Research Center, Kyoto University Graduate School of Medicine
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INANO Rika
Department of Neurosurgery, Kyoto University Graduate School of Medicine
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SHIBATA Sumiya
Department of Neurosurgery, Kyoto University Graduate School of Medicine
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YAMAO Yukihiro
Department of Neurosurgery, Kyoto University Graduate School of Medicine
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Mikuni Nobuhiro
Department of Neurological Surgery, Sapporo Medical University, Japan
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TAKAHASHI Jun
Department of Applied Chemistry and Biotechnology, University of Fukui
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