RYZÍ, Michal, Milan BRÁZDIL, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA, Hana OŠLEJŠKOVÁ, Ivan REKTOR and Robert KUBA. Long-term outcomes in patients after epilepsy surgery failure. Epilepsy Research. Amsterdam: Elsevier Science, 2015, vol. 110, February, p. 71-77. ISSN 0920-1211. doi:10.1016/j.eplepsyres.2014.11.011.
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Basic information
Original name Long-term outcomes in patients after epilepsy surgery failure
Authors RYZÍ, Michal (203 Czech Republic, guarantor, belonging to the institution), Milan BRÁZDIL (203 Czech Republic, belonging to the institution), Zdeněk NOVÁK (203 Czech Republic), Jan HEMZA (203 Czech Republic), Jan CHRASTINA (203 Czech Republic, belonging to the institution), Hana OŠLEJŠKOVÁ (203 Czech Republic, belonging to the institution), Ivan REKTOR (203 Czech Republic, belonging to the institution) and Robert KUBA (203 Czech Republic, belonging to the institution).
Edition Epilepsy Research, Amsterdam, Elsevier Science, 2015, 0920-1211.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher Netherlands
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 2.237
RIV identification code RIV/00216224:14110/15:00083356
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.eplepsyres.2014.11.011
UT WoS 000349592800010
Keywords in English Epilepsy surgery; Failure; Reoperation; Vagus nerve stimulation; Treatment options
Tags EL OK, podil
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 16. 7. 2015 09:36.
Abstract
Purpose: The primary aim of this study was to analyze the long-term outcomes of patients who were classified as Engel IV one year after resective epilepsy surgery. The secondary objectives were to evaluate the effectiveness of different treatment options and to examine the reasons that the patients did not undergo resective reoperation. Methods: Our study was designed as a retrospective open-label investigation of the long-term outcomes of 34 patients (12% of all surgically treated patients) who were classified as Engel IV one year after epilepsy surgery. Results: At the last follow-up visit (average of 7.6 +/- 4.2 years after surgery), 12 of the 34 examined patients (35.3%) were still classified as Engel IV; 22 of the 34 patients (64.7%) were improved (Engel I III). Of the 34 patients, 8 (23.5%) achieved an excellent outcome, classified as Engel I, 3 patients (8.8%) were classified as Engel II, and 11 patients (32.4%) as Engel III. The seizure outcome in the patients classified as Engel I was achieved by resective reoperation in 4; by a change in antiepileptic medication in 3 patients; and by vagus nerve stimulation (VHS) in 1 patient. The seizure outcome of Engel II was achieved by a change in antiepileptic medication in all 3 patients. Of the 34 patients, a total of 6 (17.6%) underwent resective reoperation only. The major reasons for this were the absence of a plausible hypothesis for invasive re-evaluation, the risk of postoperative deficit, and multifocal epilepsy in the rest of patients. Conclusion: Although the reoperation rate was relatively low in our series, we can achieve better or even excellent seizure outcomes using other procedures in patients for whom resective surgery initially failed.
Links
ED1.1.00/02.0068, research and development projectName: CEITEC - central european institute of technology
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