Abstract Details

Title Management of Anti-seizure Medication in Patients with Drug-resistant Focal Epilepsy Secondary to Focal Cortical Dysplasia Undergoing Epilepsy Surgery in Argentina

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-016

Objective Analyze the postoperative management of ASM in a cohort of patients with focal cortical dysplasia (FCD) in the following 10 years after surgery.

Background There is no consensus on managing anti-seizure medication (ASM) after successful epilepsy surgery.

Design/Methods Retrospective study of patients ≥18 years with a diagnosis of drug-resistant epilepsy secondary to FCD who underwent epilepsy surgery between 2008-2022. The outcome was analyzed according to the Engel Scale and changes in ASM at 1, 2, 5, and 10 years. Statistical analysis was performed in R4.2.0, considering a p-value <0.05 significant.

Results

Sixty patients were included, mean age at surgery was 38.03 years (range: 19-68). Mean time of disease evolution was 21.33 years.

The year following surgery, ASM usage began to decline. Patients used a mean of 1.91 ASM in the first year (SD 0.87), 1.62 (SD 0.97) at two years, 1.55 (SD 1.27) at five years, and 1.3 (SD 1.26) at ten years. The decrease was statistically significant (T-student (226) = -4.601, p-value < 0.00001) over the years. The model predicts a mean reduction of 0.12 ASM each year since surgery.

Patients with Engel 1 and patients who discontinued ASM over the years were: first year: 71.93% (41/57) / 1.75% (1/57); at 5 years: 71.05% (27/38) / 23.68% (9/38); at 10 years, 75% (15/20) / 40% (8/20). The increase in drug-free patients was statistically significant over the years (p-value<0.0001).

Conclusions

In our study, the percentage of seizure-free patients after surgery remained constant at 1, 2, 5, and 10 years. A statistically significant decrease in the number of ASM used throughout the follow-up was observed as well as an increase in drug-free patients.

Authors/Disclosures
Rodrigo Sanjinez, Sr., MD (Hospital Italiano de Buenos Aires) PRESENTER	Dr. Sanjinez has nothing to disclose.
Maria Burbano	No disclosure on file
Lucia Belen Varela	Lucia Belen Varela has nothing to disclose.
Carlos Andres Mateos	No disclosure on file
Yandri Garcia Fernandez	No disclosure on file
Francisco Abril, MD (Hospital Italiano de Buenos Aires)	Dr. Abril has nothing to disclose.
Gabriela Besocke	No disclosure on file
Juan Carlos Avalos	No disclosure on file
Barbara Rosso (Hospital italiano)	No disclosure on file
Walter H. Silva (Hospital Italiano)	Walter H. Silva has nothing to disclose.
Silvia Christiansen	No disclosure on file
Carlos Ciraolo	No disclosure on file
Maria del Carmen Garcia	No disclosure on file

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