Acta Neurochirurgica

, Volume 154, Issue 8, pp 1327–1336

Seizure outcome 1 year after temporal lobe epilepsy: an analysis of MR volumetric and clinical parameters

  • Christian-Andreas Mueller
  • Jasmin Scorzin
  • Marec von Lehe
  • Rolf Fimmers
  • Christoph Helmstaedter
  • Josef Zentner
  • Thomas-Nicolas Lehmann
  • Heinz-Joachim Meencke
  • Andreas Schulze-Bonhage
  • Johannes Schramm
Clinical Article

DOI: 10.1007/s00701-012-1407-0

Cite this article as:
Mueller, CA., Scorzin, J., von Lehe, M. et al. Acta Neurochir (2012) 154: 1327. doi:10.1007/s00701-012-1407-0
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Abstract

Background

The aim of this work was to determine predictors that may contribute to surgical success or failure. Relevant pre- and postoperative baseline data were analyzed, and temporal structures underwent a volumetric analysis.

Methods

A total of 207 patients (107 female) underwent complete evaluation for epilepsy surgery. Prospectively collected data used for this analysis included the clinical and demographic data. Classic prognostic factors (e.g., gender, age at operation, age at epilepsy manifestation, duration of epilepsy, education, side of pathology, intracranial EEG recordings, secondarily generalized tonic-clonic seizures, etiological factors, histology) and a volumetric analysis of 12 temporal lobe subregions were used in a regression analysis to identify possible prognostic factors in surgery for TLE. Primary outcome measure was seizure freedom at 1 year and during the full first year expressed as class I in the ILAE outcome scale.

Results

In the univariate analysis, we identified one negative predictor for a less favorable seizure outcome: intracranial EEG recordings (p = 0.010), hippocampal sclerosis as histological finding trended toward statistical significance (p = 0.054). No statistical outcome significance was found for preoperative temporal lobe compartment volume loss or postoperative lateral atrophy after mesial resection.

Conclusions

Necessity for intracranial EEG recording is an independent factor of not optimal seizure control in the 1-year follow-up. Preoperative temporal lobe volume differences including smaller mesial subcompartments did not correlate with poorer seizure outcome.

Keywords

Temporal lobe epilepsy Epilepsy surgery Outcome Predictors Volumetric MRI use in epilepsy 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Christian-Andreas Mueller
    • 1
    • 2
    • 9
  • Jasmin Scorzin
    • 1
    • 2
  • Marec von Lehe
    • 1
    • 2
  • Rolf Fimmers
    • 2
    • 3
  • Christoph Helmstaedter
    • 2
    • 4
  • Josef Zentner
    • 2
    • 5
  • Thomas-Nicolas Lehmann
    • 2
    • 6
  • Heinz-Joachim Meencke
    • 2
    • 7
  • Andreas Schulze-Bonhage
    • 2
    • 8
  • Johannes Schramm
    • 1
    • 2
  1. 1.Department of NeurosurgeryUniversity of BonnBonnGermany
  2. 2.University of BonnBonnGermany
  3. 3.Institute of Medical Biometry, Informatics and EpidemiologyUniversity of BonnBonnGermany
  4. 4.Department of EpileptologyUniversity of BonnBonnGermany
  5. 5.Department of NeurosurgeryUniversity of FreiburgFreiburgGermany
  6. 6.Department of NeurosurgeryHelios-Klinikum Bad SaarowBad SaarowGermany
  7. 7.Department of Epileptology, Epilepsiezentrum Berlin Brandenburg and von Bodelschwingsche AnstaltenKönigin Elisabeth Hospital HerzbergeBerlinGermany
  8. 8.Epilepsy CenterUniversity Hospital of Freiburg, Freiburg i.Br.FreiburgGermany
  9. 9.Department of NeurosurgeryUniversity Hospital of the Aachen University (RWTH)AachenGermany

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