Title : Epilepsy surgery outcome
Abstract:
More than 20 new anti-seizure medications have been approved by the FDA in the past 3 decades; however, epilepsy remains drug resistant in up to 40% of patients. The probability of achieving seizure freedom declines rapidly after two adequate doses of anti-seizure medication, and early referral for surgical therapy should be considered. Evidence has demonstrated the superiority of resective surgery compared to medical therapy for seizure control in patients with drug resistance epilepsy. If tow well-chosen and tolerated medication trails don’t achieve seizure control, referral to a comprehensive epilepsy center for a pre-surgical workup is appropriate. A longitudinal prospective study included patients who underwent epilepsy surgery between 2014 and 2019 was done on 2021. A total of 148 adult patients were included. Post-surgical outcomes were reported according to the Engel score, and patients were classified into two groups of Seizure Free (SF) and notseizure free (NSF). The Seizure Free outcome was reported in 86.5% of patients and antiepileptic drugs (AEDs) were reduced or discontinued in 45.9%; moreover, surgical resection is more successful for temporal epilepsy and surgery for frontal and parietal lob epilepsy is less effective. Also lesional epilepsy as determined by MRI or pathology is more likely to result in seizure freedom than non-lesional.
Keywords: Epilepsy Surgery, Lesional Epilepsy, Drug Resistance Epilepsy
Audience Take Away Notes:
- The audience will get familiar with surgery case candidate who get benefit from this approach.
- The audience will know about Drug resistance epilepsy that causes irreversible psychological and social problems, a lifetime of disability and increased risk of death. Surgical therapy improves seizure outcomes and quality of life in addition too decreasing morbidity and mortality in patients with drug resistance epilepsy.
- In this lecture it will be explained for general neurologist how to choose appropriate patients for epilepsy surgery to refer them to comprehensive epilepsy center for pre-surgical work up and discussion of surgical option.
- Appropriate epilepsy surgery will led in to decreasing morbidity including loss of independence, depression, neurological impairment and worse quality of life as well as declining the mortality rate secondary to SUDEP(Sudden unexpected Death in epilepsy), accidence and suicide
