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. 2024 May 29:27:100680.
doi: 10.1016/j.ebr.2024.100680. eCollection 2024.

Predictive factors for seizure freedom after epilepsy surgery for pediatric low-grade tumors and focal cortical dysplasia

Alena Hornak  1 , Jeffery Bolton  2 , Melissa Tsuboyama  2 , Phillip L Pearl  2 , Song Dam  2 , Trey Moore  2 , Brigitte Wilson  3 , Scellig Stone  4 , Alyssa Ailion  3
Affiliations

Predictive factors for seizure freedom after epilepsy surgery for pediatric low-grade tumors and focal cortical dysplasia

Alena Hornak et al. Epilepsy Behav Rep. .

Abstract

Epilepsy may be drug-resistant in a third of patients necessitating alternative treatments, such as surgery. Among refractory epilepsy patients, the most common etiologies are tumors and focal cortical dysplasia (FCD). Surgical management of tumor-related epilepsy has one of the highest rates of seizure freedom, whereas FCD represents some of the lowest success rates in epilepsy treatment. This study investigates the pre-operative characteristics associated with differences in postsurgical seizure outcomes in patients with FCD and tumors. We completed a retrospective cross-sectional review of epilepsy surgery patients with tumors (n = 29) or FCD (n = 44). Participants had a minimum medical follow-up at least 6 months after surgery (FCD M = 2.1 years; Tumors M = 2.0 years). Patients with FCD trended toward an earlier age of onset (t = -4.19, p = 0.058) and longer epilepsy duration (t = 3.75, p < 0.001). Epilepsy surgery is highly effective in reducing seizures in patients with FCD or tumors with over 70 % of all patients achieving seizure freedom. We found a higher rate of seizure freedom in patients with tumors than FCD, but this difference did not reach significance (79 vs. 66 %). Predictive factors of outcomes for FCD and tumors differ. Findings indicate that diagnostic tests may be differentially sensitive to patients with tumors, and future research is needed.

Keywords: Epilepsy; FCD; Low-Grade Tumors; Pediatric; Seizure Outcomes; Surgery.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Displays seizure outcomes for patients based on epilepsy lesion location/SOZ and etiology.
Fig. 2
Fig. 2
Displays seizure outcomes for patients based on epilepsy lesion location/SOZ and surgical resection status.
See this image and copyright information in PMC

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