Abstract Details

Title Long-term Outcomes in Surgical Patients with Intractable Temporal Lobe Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S25 - Epilepsy/Clinical Neurophysiology (EEG) 2 (1:24 PM-1:36 PM)

Poster/Presentation
Number 003

Objective To determine the long term outcomes of epilepsy surgery at a comprehensive epilepsy center.

Background Despite new anti-epileptic therapy options, more than 30% of patients with epilepsy will become medically intractable. There have been many studies demonstrating the efficacy of temporal lobe surgery in short term follow up, but fewer studies with long term seizure freedom data.

Design/Methods Upon IRB approval we performed a retrospective review of 162 patients that had temporal lobe surgery at Rush University Medical Center between 1/18/96-2/5/09. Patients’ surgical outcome using the Engel classification was documented at 5, 10, 15, and 20 years in addition to the most recent follow up appointment.

Results 162 patients (91 female, 71 male) met inclusion criteria. 20 patients were lost to follow up and excluded from the analysis. Patients were followed for an average of 13.3 years (± 5.2 years). 110 patients were Engel class I, 78 of which were class 1A at their last follow up. Neither age of onset nor duration of epilepsy at surgery were associated with a particular outcome, likewise pre-operative seizure frequency did not predict seizure outcome post-operatively. At last follow up appointment, 86% of those who underwent a left temporal lobectomy versus 66% after a right temporal lobectomy, achieved seizure freedom, p = 0.002.

Conclusions This large cohort of patients with temporal lobe epilepsy demonstrates that the majority of patients achieve long term seizure freedom after temporal lobe resection. Further analysis is currently underway to determine predictive factors of outcome, as initial analysis yielded unexpected results. Left temporal lobectomy outcomes were better and could be due to a more thorough and certain work up given the dominant temporal lobe being resected. Seizure freedom remained relatively consistent, suggesting that early seizure freedom post-operatively will be maintained long-term.

Authors/Disclosures
Jake Torrison, MD (University of Minnestoa, Department of Neurology) PRESENTER	No disclosure on file
Allison Osen, MD (Rush University Medical Center)	No disclosure on file
Sepehr Sani	The institution of Sepehr Sani has received research support from NIH. Sepehr Sani has received intellectual property interests from a discovery or technology relating to health care. Sepehr Sani has received publishing royalties from a publication relating to health care.
Richard E. Byrne, MD	No disclosure on file
Bichum Ouyang	Bichum Ouyang has nothing to disclose.
Rebecca O'Dwyer, MD (Rush University Medical Center)	Dr. O'Dwyer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. O'Dwyer has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for SK Life Sciences.

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