RYZÍ, Michal, Hana OŠLEJŠKOVÁ, Ivan REKTOR, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA, Michal SVOBODA, Markéta HERMANOVÁ and Milan BRÁZDIL. Long-term approach to patients with postsurgical seizures. Epilepsia. Hoboken: Wiley-Blackwell, 2016, vol. 57, No 4, p. 597-604. ISSN 0013-9580. Available from: https://dx.doi.org/10.1111/epi.13343. |
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@article{1364023, author = {Ryzí, Michal and Ošlejšková, Hana and Rektor, Ivan and Novák, Zdeněk and Hemza, Jan and Chrastina, Jan and Svoboda, Michal and Hermanová, Markéta and Brázdil, Milan}, article_location = {Hoboken}, article_number = {4}, doi = {http://dx.doi.org/10.1111/epi.13343}, keywords = {Surgery failure; Postoperative treatment; Add-on medication; Reoperation; Vagus nerve stimulation}, language = {eng}, issn = {0013-9580}, journal = {Epilepsia}, title = {Long-term approach to patients with postsurgical seizures}, volume = {57}, year = {2016} }
TY - JOUR ID - 1364023 AU - Ryzí, Michal - Ošlejšková, Hana - Rektor, Ivan - Novák, Zdeněk - Hemza, Jan - Chrastina, Jan - Svoboda, Michal - Hermanová, Markéta - Brázdil, Milan PY - 2016 TI - Long-term approach to patients with postsurgical seizures JF - Epilepsia VL - 57 IS - 4 SP - 597-604 EP - 597-604 PB - Wiley-Blackwell SN - 00139580 KW - Surgery failure KW - Postoperative treatment KW - Add-on medication KW - Reoperation KW - Vagus nerve stimulation N2 - Objective: The main purpose of the study was to analyze the long-term outcomes and therapeutic approaches for patients with seizures within the first year after surgery. The secondary aim of the study was to evaluate the relationship between 1-year outcome and long-term outcome and choice of therapy. Methods: Our study was a retrospective investigation of the long-term outcomes of 95 patients (33.5% of all surgically treated patients) with seizure recurrence in the first year after surgery. The patients had follow-up visits for >5 years. Results: At the 5-year follow-up visit (FU5), 28 (29.5%) of the 95 patients were completely seizure-free (International League Against Epilepsy (ILAE) class 1), 17 (17.9%) had auras only (ILAE class 2), and 21 (22.1%) were unimproved (ILAE classes 5 and 6). Statistically significant factors for these long-term outcomes were the focus localization of the epilepsy, preoperative MRI findings, and postoperative follow-up results in the first year. The patients with <3 seizure days in the first postoperative year (ILAE 3) represented 53.6% of the seizure-free patients at FU5; the patients with auras in the first year constituted 64.7% of the patients with only auras at FU5; and the patients unimproved in the first year represented 76.2% of the unimproved patients at FU5. Significance: Postoperative outcome depends to a certain extent on the outcome achieved in the first postoperative year. More than one third of the patients with postoperative seizures reached a long-term seizure-free outcome, and more than half of them did not experience disabling seizures in the last outcome year. The most therapeutic options were used in patients who were minimally influenced by the operation; the majority of patients with considerable improvement because of the operation do not use any other add-on antiepileptic drugs or other kinds of therapy. ER -
RYZÍ, Michal, Hana OŠLEJŠKOVÁ, Ivan REKTOR, Zdeněk NOVÁK, Jan HEMZA, Jan CHRASTINA, Michal SVOBODA, Markéta HERMANOVÁ and Milan BRÁZDIL. Long-term approach to patients with postsurgical seizures. \textit{Epilepsia}. Hoboken: Wiley-Blackwell, 2016, vol.~57, No~4, p.~597-604. ISSN~0013-9580. Available from: https://dx.doi.org/10.1111/epi.13343.
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