Surgical Outcomes in Post-Traumatic Epilepsy: A Metanalysis
Abstract number :
3.436
Submission category :
9. Surgery / 9A. Adult
Year :
2022
Submission ID :
2232918
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Zulfi Haneef, MBBS, MD – Michael E. DeBakey VA Medical Center; Liam Ferreira, BS – Baylor College of Medicine; Mohammad Tabaeizadeh Fesharak, MD – Baylor College of Medicine
This is a Late Breaking abstract
Rationale: It is unclear whether epilepsy surgery outcomes in post-traumatic epilepsy (PTE) are as robust as has been described for drug-resistant epilepsy (DRE) in general. Prior surgical outcome studies in PTE are limited by small numbers, lack of a control group, or both. We performed a meta-analysis of the available literature to evaluate surgical outcomes in PTE compared with non-PTE DRE.
Methods: PubMed, EMBASE, and Web of Science databases were queried for studies evaluating epilepsy surgery in PTE, dividing outcomes into Engel Class I or Class II-IV for comparison. Meta-Analyses were performed to evaluate (1) outcomes of epilepsy surgery in PTE and (2) comparison of surgical outcomes in PTE and non-PTE DRE. Odds ratios and 95% confidence intervals were reported.
Results: From 3669 articles identified, 22 were selected for the final analysis which reported the outcome of epilepsy surgery in PTE (n= 515 patients with DRE with PTE), Engel Class I outcome was seen in 61.5% (95% CI, 52.6-70.3%). Among these, 13 studies reported outcomes not only for DRE with PTE (n=285), but also in patients with DRE without PTE (n=838) – the odds of Class I outcomes in PTE compared to non-PTE DRE was 0.694 (95% CI, 0.458-1.105, not significant).
Conclusions: The likelihood of Engel Class 1 outcome following epilepsy surgery in PTE is similar to outcomes reported among all DRE, and compared to control groups without PTE, suggesting that the presence of PTE should not detract from consideration of epilepsy surgery.
Funding: Michael E. DeBakey VA Medical Center Bridge and Seed Funding, Michael Hogg fund
Surgery