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Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region

OBJECTIVE: Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug‐resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed...

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Autores principales: Mir, Ali, Jallul, Tarek, Alotaibi, Faisal, Amer, Fawzia, Najjar, Ahmed, Alhazmi, Rami, Al Faraidy, Mona, Alharbi, Alanoud, Aldurayhim, Fatimah, Barnawi, Zakia, Fallatah, Bassam, Ali, Mona, Almuhaish, Husam, Almolani, Fadhel, Suwailem, Abdullah, Tuli, Mahmoud, Naim, Abdulrahman, Hassan, Suad, Hedgcock, Brent, Bostanji, Ghadah, Bashir, Shahid, AlBaradie, Raidah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472393/
https://www.ncbi.nlm.nih.gov/pubmed/37162422
http://dx.doi.org/10.1002/epi4.12761
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author Mir, Ali
Jallul, Tarek
Alotaibi, Faisal
Amer, Fawzia
Najjar, Ahmed
Alhazmi, Rami
Al Faraidy, Mona
Alharbi, Alanoud
Aldurayhim, Fatimah
Barnawi, Zakia
Fallatah, Bassam
Ali, Mona
Almuhaish, Husam
Almolani, Fadhel
Suwailem, Abdullah
Tuli, Mahmoud
Naim, Abdulrahman
Hassan, Suad
Hedgcock, Brent
Bostanji, Ghadah
Bashir, Shahid
AlBaradie, Raidah
author_facet Mir, Ali
Jallul, Tarek
Alotaibi, Faisal
Amer, Fawzia
Najjar, Ahmed
Alhazmi, Rami
Al Faraidy, Mona
Alharbi, Alanoud
Aldurayhim, Fatimah
Barnawi, Zakia
Fallatah, Bassam
Ali, Mona
Almuhaish, Husam
Almolani, Fadhel
Suwailem, Abdullah
Tuli, Mahmoud
Naim, Abdulrahman
Hassan, Suad
Hedgcock, Brent
Bostanji, Ghadah
Bashir, Shahid
AlBaradie, Raidah
author_sort Mir, Ali
collection PubMed
description OBJECTIVE: Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug‐resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed a retrospective study examining the outcomes of resective surgery in 53 pediatric patients with focal DRE. METHODS: Patients with focal DRE who had undergone epilepsy surgery were included in the present study. All patients underwent a comprehensive presurgical evaluation. Postoperative seizure outcomes were classified using the Engel Epilepsy Surgery Outcome Scale. RESULTS: After surgery, 33 patients (62.2%) were Class I according to the Engel classification of surgical outcomes; eight patients (15.0%) were Class II, 11 (20.7%) were Class III, and one (1.8%) was Class IV. The relationships of presurgical, surgical, and postsurgical clinical variables to seizure outcomes were compared. Older age at seizure onset, older age at the time of surgery, the presence of focal to bilateral tonic–clonic seizures, seizure duration over 2 minutes, unsuccessful treatment with three or fewer antiseizure medications, lesions confined to one lobe (as demonstrated via magnetic resonance imaging [MRI]), surgical site in the temporal lobe, and histopathology including developmental tumors were significantly linked to an Engel Class I outcome. A univariate analysis of excellent surgical outcomes showed that lateralized semiology, localized interictal and ictal electroencephalogram (EEG) discharges, lateralized single‐photon emission computed tomography and positron emission tomography findings, and temporal lobe resections were significantly related to excellent seizure outcomes. SIGNIFICANCE: The results of our study are encouraging and similar to those found in other centers around the world. Epilepsy surgery remains an underutilized treatment for children with DRE and should be offered early.
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spelling pubmed-104723932023-09-02 Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region Mir, Ali Jallul, Tarek Alotaibi, Faisal Amer, Fawzia Najjar, Ahmed Alhazmi, Rami Al Faraidy, Mona Alharbi, Alanoud Aldurayhim, Fatimah Barnawi, Zakia Fallatah, Bassam Ali, Mona Almuhaish, Husam Almolani, Fadhel Suwailem, Abdullah Tuli, Mahmoud Naim, Abdulrahman Hassan, Suad Hedgcock, Brent Bostanji, Ghadah Bashir, Shahid AlBaradie, Raidah Epilepsia Open Original Articles OBJECTIVE: Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug‐resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed a retrospective study examining the outcomes of resective surgery in 53 pediatric patients with focal DRE. METHODS: Patients with focal DRE who had undergone epilepsy surgery were included in the present study. All patients underwent a comprehensive presurgical evaluation. Postoperative seizure outcomes were classified using the Engel Epilepsy Surgery Outcome Scale. RESULTS: After surgery, 33 patients (62.2%) were Class I according to the Engel classification of surgical outcomes; eight patients (15.0%) were Class II, 11 (20.7%) were Class III, and one (1.8%) was Class IV. The relationships of presurgical, surgical, and postsurgical clinical variables to seizure outcomes were compared. Older age at seizure onset, older age at the time of surgery, the presence of focal to bilateral tonic–clonic seizures, seizure duration over 2 minutes, unsuccessful treatment with three or fewer antiseizure medications, lesions confined to one lobe (as demonstrated via magnetic resonance imaging [MRI]), surgical site in the temporal lobe, and histopathology including developmental tumors were significantly linked to an Engel Class I outcome. A univariate analysis of excellent surgical outcomes showed that lateralized semiology, localized interictal and ictal electroencephalogram (EEG) discharges, lateralized single‐photon emission computed tomography and positron emission tomography findings, and temporal lobe resections were significantly related to excellent seizure outcomes. SIGNIFICANCE: The results of our study are encouraging and similar to those found in other centers around the world. Epilepsy surgery remains an underutilized treatment for children with DRE and should be offered early. John Wiley and Sons Inc. 2023-06-07 /pmc/articles/PMC10472393/ /pubmed/37162422 http://dx.doi.org/10.1002/epi4.12761 Text en © 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Mir, Ali
Jallul, Tarek
Alotaibi, Faisal
Amer, Fawzia
Najjar, Ahmed
Alhazmi, Rami
Al Faraidy, Mona
Alharbi, Alanoud
Aldurayhim, Fatimah
Barnawi, Zakia
Fallatah, Bassam
Ali, Mona
Almuhaish, Husam
Almolani, Fadhel
Suwailem, Abdullah
Tuli, Mahmoud
Naim, Abdulrahman
Hassan, Suad
Hedgcock, Brent
Bostanji, Ghadah
Bashir, Shahid
AlBaradie, Raidah
Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title_full Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title_fullStr Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title_full_unstemmed Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title_short Outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: A single‐center study from the Eastern Mediterranean Region
title_sort outcomes of resective surgery in pediatric patients with drug‐resistant epilepsy: a single‐center study from the eastern mediterranean region
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472393/
https://www.ncbi.nlm.nih.gov/pubmed/37162422
http://dx.doi.org/10.1002/epi4.12761
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