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Meta-Analysis
. 2023 Apr 18;46(1):91.
doi: 10.1007/s10143-023-01997-3.

Efficiency of surgery on posttraumatic epilepsy: a systematic review and meta-analysis

Xueping Wang  1 , Pengna Han  1 , Qiang Wang  1 , Chen Xie  1 , Jun Chen  2
Affiliations
Meta-Analysis

Efficiency of surgery on posttraumatic epilepsy: a systematic review and meta-analysis

Xueping Wang et al. Neurosurg Rev. .

Abstract

Posttraumatic epilepsy (PTE) accounts for approximately 20% of structural epilepsy, and surgical intervention may be a potential treatment option for these patients. Therefore, the purpose of this meta-analysis is to evaluate the effectiveness of surgical interventions for the management of PTE. Four electronic databases (Pubmed, Embase, Scopus and Cochrane library) were searched to identify studies on surgical management of PTE. Seizures reduction rate were analyzed quantitatively in a meta-analysis. Fourteen studies involving 430 PTE patients were selected for analysis, out of which 12 reported on resective surgery (RS), 2 on vagus nerve stimulation (VNS), and 2 of the 12 RS studies reported that 14 patients underwent VNS. The seizure reduction rate for surgical interventions (both RS and VNS) was 77.1% (95% confidence interval [CI]: 69.8%-83.7%) with moderate heterogeneity (I2 = 58.59%, Phetero = 0.003). Subgroup analysis based on different follow-up times revealed that the seizure reduction rate was 79.4% (95% CI: 69.1%-88.2%) within 5 years and 71.9% (95% CI: 64.5%-78.8%) beyond 5 years. The seizure reduction rate for RS alone was 79.9% (95% CI: 70.3%-88.2%) with high heterogeneity (I2 = 69.85%, Phetero = 0.001). Subgroup analysis showed that the seizure reduction rate was 77.9% (95% CI: 66%-88.1%) within 5 years and 85.6% (95% CI: 62.4%-99.2%) beyond 5 years, with 89.9% (95% CI: 79.2%-97.5%) for temporal lobectomy and 84% (95% CI: 68.2%-95.9%) for extratemporal lobectomy. The seizure reduction rate for VNS alone was 54.5% (95% CI: 31.6%-77.4%). Surgical interventions appeared to be effective for PTE patients without severe complications, RS seemed more beneficial than VNS, while temporal lobectomy is more favorable than extratemporal resection. However, further studies with long-term follow-up data are needed to better understand the relationship between VNS and PTE.

Keywords: Epilepsy surgery; Posttraumatic epilepsy; Resective surgery; Vagus nerve stimulation.

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References

    1. Ferguson PL et al (2010) A population-based study of risk of epilepsy after hospitalization for traumatic brain injury. Epilepsia 51(5):891–898 - DOI - PubMed
    1. Maas AI, Stocchetti N, Bullock R (2008) Moderate and severe traumatic brain injury in adults. Lancet Neurol 7(8):728–741 - DOI - PubMed
    1. Hauser WA, Annegers JF, Kurland LT (1993) Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia 34(3):453–468 - DOI - PubMed
    1. Annegers JF et al (1998) A population-based study of seizures after traumatic brain injuries. N Engl J Med 338(1):20–24 - DOI - PubMed
    1. Englander J et al (2003) Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Arch Phys Med Rehabil 84(3):365–373 - DOI - PubMed

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