International Journal of Epilepsy 2015; 02(02): 078-083
DOI: 10.1016/j.ijep.2015.11.001
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Predictors of outcome of surgery in adults with mesial lesional temporal lobe epilepsy

Manas Panigrahi
d  Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad 03, Telangana, India
,
Sudhindra Vooturi
a  Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad 03, Telangana, India
,
Rammohan Vadapalli
b  Department of Radiology, Vijaya Diagnostic Centre, Hyderabad, India
,
Shanmukhi Somayajula
a  Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad 03, Telangana, India
,
Sailaja Madigubba
c  Department of Pathology, Krishna Institute of Medical Sciences, Secunderabad 03, Telangana, India
,
Sita Jayalakshmi
a  Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad 03, Telangana, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

Received: 01 June 2015

Accepted: 19 November 2015

Publication Date:
06 May 2018 (online)

Abstract

Background We report the clinical characteristics and outcome of epilepsy surgery in adult patients with intractable epilepsy due to isolated lesional temporal lobe epilepsy (TLE).

Methods Retrospective analysis of clinical and outcome characteristics in 47 consecutive adult patients with intractable epilepsy due to isolated lesional TLE who underwent epilepsy surgery from November 2009 to January 2015 was done to predictors of outcome.

Results The mean age at surgery of the study population was 30.74 ± 10.85 years with 20 (43.5%) women. While the average age at onset of epilepsy was 20.12 ± 12.52 years, average duration of epilepsy was 10.78 ± 7.96 years. Favourable Engels outcome was observed in 39 (84.8%) of the patients. Findings on histopathology reported glioma in 24 (52.0%) of the patients. On comparing patients with favourable outcome (n = 39) with those with unfavourable outcome (n = 7), age at surgery was significantly higher in patients with unfavourable outcome (40.14 ± 11.69 years vs 29.05 ± 9.92 years; p = 0.011). Higher percentage of patients with unfavourable outcome scored poor on pre-surgical IQ tests (42.9% vs 7.7%; p = 0.037). On further analysis for predictors of outcome, age at surgery (β = 0.858; 95% CI 0.738–0.997) significantly predicts outcome (β = 1.166; 95% CI 0.931–1.461; p = 0.182), whereas pre-surgical poor IQ showed a trend towards being associated with unfavourable outcome (β = 0.079; 95% CI 0.005–1.287; p = 0.075).

Conclusion Surgery for intractable epilepsy due to isolated lesional TLE has favourable outcome in vast majority (84.8%) of carefully selected patients. Age at surgery predicts outcome in these patients.