Abstracts

To evaluate the long-term seizure outcome of 15 years of extratemporal neocortical epilepsy surgery of adults in the Bethel Epilepsy Center comparing the outcome between patients operated in three consecutive 5-year periods., Between 1991 and 2006, 221 adult patients with extratemporal drug resistant epilepsies were operated on. From 221 patients 28 patients (12.6%) had more than one operation, five patients (2.6%) received VNS. We retrospectively reviewed the outcome of all patients. Patients with Rasmussen[apos]s encephalitis and those who only had a biopsy were excluded. Data was gathered by reviewing hospital files, outpatient reports, two-year in-patient postoperative follow-up results, and using mail and telephone questionnaires. Three patients were not available for review, six patients died, and in ten patients data was incomplete.
Patients were divided into three groups, depending on the time of operation: group 1 (1991-1995), group 2 (1995-2000), and group 3 (2000-2005)., Group 1: (54 patients, 24.4%) mean age of patients at seizure onset in years 10.6 [plusmn] 8.8 (range 1-41), mean age at surgery 28.13 [plusmn] 10.3 (range 16-57), mean duration of epilepsy 17.4 [plusmn] 9.7 (range 1 to 38), mean duration of follow-up 11.4 [plusmn] 2.09 (range 1 to 14); outcome class 1 at the 6-month follow-up (47.0%), after 1 year (48.5%), 2 years (45.5%), 5 years (46.6%).
Group 2: (90 patients, 40.7%), mean age at seizure onset 13.4 [plusmn] 10.4 (range 0.8-52), mean age at surgery 28.02 [plusmn] 10.1 (range 16-59), mean duration of epilepsy 15.6 [plusmn] 9.2 (range 0-44), mean duration of follow-up 7.6 [plusmn] 1.6 (range 2-10 yrs); outcome class 1 at the follow-up after 6 months (53.4%), 1 year (50.0%), 2 years (50.0%), 5 years (53.7%).
Group 3: (77 patients, 34.4%) mean age at seizure onset 16.8 [plusmn] 15.0 (range 0.4-65), mean age at surgery 31.1[plusmn] 13.1 (range 16-69), mean duration of epilepsy 14.2 [plusmn] 13.2 (range 0-64), mean duration of follow-up 2.6 [plusmn] 1.5 (range 0.5-5 yrs); outcome class 1 at the follow-up after 6 months (63.5%), 1 year (57.1%), 2 years (61.9%), 5 years (57.9%). A statistically significant difference was only found in the the 2-year outcome group (p=0.002)., The comparison of postoperative seizure outcome of extratemporal epilepsy surgery in adults over the last 15 years shows mixed results. A statistically significant improvement was seen only in the two-year postoperative outcome whereas at other points in time there was a tendency for improvement.,