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. 2022;32(3):386-391.
doi: 10.5137/1019-5149.JTN.33806-21.2.

Factors Affecting Seizure Outcomes After Surgery for Cavernoma Related Epilepsy

Fatma Ozlen  1 , Cihan Isler, Mehmet Yigit Akgun, Cigdem Ozkara, Mert Karabacak, Sakir Delil, Basak Yilmaz Oz, Burak Tahmazoglu, Mustafa Uzan
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Free article

Factors Affecting Seizure Outcomes After Surgery for Cavernoma Related Epilepsy

Fatma Ozlen et al. Turk Neurosurg. 2022.
Free article

Abstract

Aim: To present one of the largest retrospective cavernoma related epilepsy (CRE) studies which include divergent supratentorial locations operated and followed up at least 2 years. We also investigated the factors affecting the seizure outcome.

Material and methods: This study includes a total of 56 patients with drug-responsive (n=40) and drug-resistant (n=16) CRE who underwent resective surgery. Age at seizure onset, age at surgery, gender, duration of epilepsy, seizure frequencies/type before and after treatment, EEG and brain MRI findings, prescribed AEDs, preoperative and post-operative neurological status, histopathological diagnosis, post-operative seizure outcomes and surgical information were documented.

Results: The average follow-up period was 69.6 months (range 24-216 months). The seizure outcome was assessed according to Engel?s classification at the last follow-up. Engel class I was achieved in 53 patients (95%); there was one patient at class II and two patients at class III. All patients in the drug-responsive group were at Engel class I after the surgery, while all patients at Engel classes II and III were in the drug-resistant patient group. This clearly shows that there were better outcomes in DRP group (p < 0.01). Neither the locations of cavernomas nor the duration of epilepsy had any impact on seizure outcome (p > 0.05).

Conclusion: An earlier surgical intervention may prevent the patients from becoming drug-resistant such that their chances of being seizure free after surgery increase.

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