Abstracts

The success of epilepsy surgery in mesial temporal lobe epilepsy due to hippocampal sclerosis (MTS) reaches a 60% rate of success, based on a randomized control trial. Observational studies from different epilepsy centers worldwide indicate up to a 93% rate of success. Several risk factors are attributed to the recurrence of seizures following the surgical procedure. Nonetheless whether race influences the outcome of temporal lobe surgery is unknown. The purpose of the study was to evaluate if race plays a role in outcome following surgery. Data was obtained from the discharge database of the University of Alabama at Birmingham, video-EEG monitoring unit, between 1998 and 2003, and the clinical charts. Seizure recurrence was evaluated 1 year following surgery. The sample consisted of all patients discharged with a primary diagnosis of MTS who underwent an anterior temporal lobectomy. Multiple logistic regression analysis was used to model the presence of seizure recurrence after anterior temporal lobectomy for MTS. Two sets of logistic regression models were estimated to generate odds ratios (ORs) for seizure recurrence after an anterior temporal lobectomy for African Americans or other possible ethnic/racial group present relative to Non-hispanic Caucasians. The first model incorporated only ethnicity as the independent variable and generated unadjusted odds ratios for receiving the surgical procedure. The second set included the independent variables: duration of epilepsy, history of febrile seizures, lateralization of epileptogenic focus, handedness, and age. Of a total of 432 patients diagnosed with TLE, 130 had evidence of MTS on MRI studies. Seventy patients underwent surgical treatment and all of them had pathologic confirmation of mesial temporal sclerosis. Clinical information in five of them was incomplete. Analysis of the remaining 65 patients revealed that African-Americans were more likely than non-hispanic whites to have seizure recurrence after surgery (Odds Ratio=2.2, 95%CI: 0.6-8.2), even though this finding was not statistically significant. After potential clinical confounders (duration of epilepsy, history of febrile seizures, lateralization of epileptogenic focus, handedness, and age) were controlled, the significance of this finding did not change (Odds Ratio=1.3, 95%CI: 0.2-8.7). Our data suggest that race does not appear to be an important factor related to seizure outcome.