Abstract Details

Title Predictors of Surgical Outcome in Frontal Lobe Epilepsy: Experience from a Single-center Cohort in Latin America

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 10-004

Objective

Describe the clinical, imaging, surgical, and histopathological characteristics of a cohort of patients with frontal lobe epilepsy (FLE) who underwent resective epilepsy surgery at a referral center in Bogotá, Colombia, and to identify factors associated with favorable surgical outcomes.

Background Frontal lobe epilepsy (FLE) is the second most common type of focal epilepsy and among the most challenging to diagnose and treat. Although surgical resection offers potential seizure freedom, outcomes vary, and high-quality data from low- and middle-income countries are scarce. This study aimed to describe a cohort of patients with FLE undergoing epilepsy surgery and identify factors associated with favorable outcomes.

Design/Methods A retrospective observational study was conducted on 40 consecutive patients with drug-resistant FLE who underwent resective epilepsy surgery at a center in Bogotá, Colombia, between 2016 and 2024. Data on clinical features, neuroimaging, surgery, and histopathology were collected. Surgical outcomes were classified using the Engel Epilepsy Surgery Outcome Scale; Engel class I or II was considered favorable. Bivariate analyses were performed to identify predictors of good outcomes.

Results Median age at surgery was 25.5 years (IQR: 14.8–34.8); 67.5% were male and 92.5% right-handed. Semiological group 1 (motor/premotor cortex) was most common (75%). MRI revealed focal cortical dysplasia or gliosis in 12.5% each; 37.5% had normal imaging. Histopathology confirmed dysplasia in 17.5%, gliosis in 12.5%, and was normal in 37.5%. At median 29.7 months follow-up, 57.5% achieved favorable outcomes. Normal histopathology was significantly associated with poor outcomes (p = 0.003). Trends toward better outcomes were seen in patients with standard resections (p = 0.053) and identifiable lesions, though not statistically significant.

Conclusions Epilepsy surgery for FLE is feasible and safe in middle-income countries and can yield outcomes similar to global reports. These results underscore the importance of early referral, detailed semiological analysis, and lesion detection for surgical planning in drug-resistant FLE.

Authors/Disclosures
Diana M. Riaño, MD PRESENTER	Dr. Riaño has nothing to disclose.
Andres Felipe Cardenas Cruz, Jr., MD (Javeriana)	Dr. Cardenas Cruz has nothing to disclose.
Juan J. Ramirez	Mr. Ramirez has nothing to disclose.
Carmela E. Fawcett, MD	Dr. Fawcett has nothing to disclose.
Santiago Martinez Corredor	Mr. Navarra has nothing to disclose.
Sergio Esteban Chacón Valencia, MD	Dr. Chacón Valencia has nothing to disclose.
DANIEL NARIÑO GONZALEZ (Abbott Colombia)	No disclosure on file

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