Long-term outcomes in patients after epilepsy surgery failure

J 2015

Long-term outcomes in patients after epilepsy surgery failure

RYZÍ, Michal, Milan BRÁZDIL, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA et. al.

Základní údaje

Originální název

Long-term outcomes in patients after epilepsy surgery failure

Autoři

RYZÍ, Michal (203 Česká republika, garant, domácí), Milan BRÁZDIL (203 Česká republika, domácí), Zdeněk NOVÁK (203 Česká republika), Jan HEMZA (203 Česká republika), Jan CHRASTINA (203 Česká republika, domácí), Hana OŠLEJŠKOVÁ (203 Česká republika, domácí), Ivan REKTOR (203 Česká republika, domácí) a Robert KUBA (203 Česká republika, domácí)

Vydání

Epilepsy Research, Amsterdam, Elsevier Science, 2015, 0920-1211

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 2.237

Kód RIV

RIV/00216224:14110/15:00083356

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.eplepsyres.2014.11.011

UT WoS

000349592800010

Klíčová slova anglicky

Epilepsy surgery; Failure; Reoperation; Vagus nerve stimulation; Treatment options

Štítky

EL OK, podil

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 16. 7. 2015 09:36, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

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.

Návaznosti

ED1.1.00/02.0068, projekt VaV

Název: CEITEC - central european institute of technology

Přiložené soubory

EL_1305920.pdf

Požádat o autorskou verzi souboru

Citovat

RYZÍ, Michal, Milan BRÁZDIL, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA, Hana OŠLEJŠKOVÁ, Ivan REKTOR a Robert KUBA. Long-term outcomes in patients after epilepsy surgery failure. Epilepsy Research. Amsterdam: Elsevier Science, 2015, roč. 110, February, s. 71-77. ISSN 0920-1211. Dostupné z: https://dx.doi.org/10.1016/j.eplepsyres.2014.11.011.

@article{1305920,
   author = {Ryzí, Michal and Brázdil, Milan and Novák, Zdeněk and Hemza, Jan and Chrastina, Jan and Ošlejšková, Hana and Rektor, Ivan and Kuba, Robert},
   article_location = {Amsterdam},
   article_number = {February},
   doi = {http://dx.doi.org/10.1016/j.eplepsyres.2014.11.011},
   keywords = {Epilepsy surgery; Failure; Reoperation; Vagus nerve stimulation; Treatment options},
   language = {eng},
   issn = {0920-1211},
   journal = {Epilepsy Research},
   title = {Long-term outcomes in patients after epilepsy surgery failure},
   volume = {110},
   year = {2015}
}

TY  - JOUR
ID  - 1305920
AU  - Ryzí, Michal - Brázdil, Milan - Novák, Zdeněk - Hemza, Jan - Chrastina, Jan - Ošlejšková, Hana - Rektor, Ivan - Kuba, Robert
PY  - 2015
TI  - Long-term outcomes in patients after epilepsy surgery failure
JF  - Epilepsy Research
VL  - 110
IS  - February
SP  - 71-77
EP  - 71-77
PB  - Elsevier Science
SN  - 09201211
KW  - Epilepsy surgery
KW  - Failure
KW  - Reoperation
KW  - Vagus nerve stimulation
KW  - Treatment options
N2  - 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.
ER  -

RYZÍ, Michal, Milan BRÁZDIL, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA, Hana OŠLEJŠKOVÁ, Ivan REKTOR a Robert KUBA. Long-term outcomes in patients after epilepsy surgery failure. \textit{Epilepsy Research}. Amsterdam: Elsevier Science, 2015, roč.~110, February, s.~71-77. ISSN~0920-1211. Dostupné z: https://dx.doi.org/10.1016/j.eplepsyres.2014.11.011.

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