Refractory Epilepsy: Analysis of Cases Submitted to Surgical Treatment at Angelina Caron Hospital

Rationale: This study aims to present the epidemiological and postoperative profiles of patients surgically treated for refractory epilepsy at Angelina Caron Hospital, in order to provide comparable information with data described in literature and, thus, contribute to improve its medical care.

Methods: Through a retrospective data-based study of 63 medical records of patients submitted to surgical treatment for refractory epilepsy, performed from July 2010 to November 2016 at Angelina Caron Hospital located in Campina Grande do Sul city in the state of Paraná, Brazil. It was aimed to analyse the postoperative data and classifying it according to the Engel scale. A descriptive analysis was performed through frequency calculations and central tendency measures, with the respective 95% confidence intervals.

Results: Epidemiological data revealed a predominance of female patients (55%). The most common etiologic diagnosis was mesial temporal sclerosis (78.5%) followed by brain tumor (21.4%). Regarding the previous pharmacological treatment, 60% were on antiepileptic drugs for more than 20 years. The mean age at the time of surgery was 34.5 years. Seven cases of immediate postoperative complications (12.5%) were recorded (transient weakness or dysphasia and visual field deficits, cerebral hemorrhage). By follow-up records, 39 patients (69.6%) presented an Engel I classification (free of disabiling seizures), 7 of them (12.5%) had an Engel II classification (rare disabiling seizures), 6 patients (10.7%) had an Engel III rating (worthwhile improvement) and 4 (7.1%) presented a classification IV (no worthwhile improvement) – this last group was composed of 3 patients with brain tumor and 1 patient with temporal mesial sclerosis. Among the group of patients wich had remunerated activity, 60.4% reported returning to work on postoperatively and 85.7% of the total sample described an evident improvement in the quality of life after surgical treatment, corresponding to the expressive majority of the sample.

Conclusions: Surgical treatment is well-established option for the management of refractoryepilepsy. The results observed in the present study allows to conclude that the surgery was effective for the majority of patients with refractory epilepsy treated at Angelina Caron Hospital, whose epidemiological profile is similar to that described in the world’s literature.