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Long term follow-up of the first 70 operated adults in the Goteborg Epilepsy Surgery Series with respect to seizures, psychosocial outcome and use of antiepileptic drugs

Journal article
Authors Fredrik Asztely
Gerd Ekstedt
Bertil Rydenhag
Kristina Malmgren
Published in J Neurol Neurosurg Psychiatry
Volume 78
Issue 6
Pages 605-9
ISSN 1468-330X (Electronic)
Publication year 2007
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 605-9
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Adolescent, Adult, Aged, Anticonvulsants/therapeutic use, Child, Child, Preschool, Depression/etiology, Epilepsy/complications/drug therapy/*psychology/*surgery, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Neurosurgical Procedures/adverse effects, Psychology, Quality of Life, Time Factors, Treatment Outcome
Subject categories Neurology

Abstract

OBJECTIVE: To compare long term (10 years) seizure outcome, psychosocial outcome and use of antiepileptic drugs (AED) with the 2 year follow-up in adults after resective epilepsy surgery. METHODS: All adults (n = 70) who underwent resective epilepsy surgery from 1987 to 1995 in the Goteborg Epilepsy Surgery Series were included. Fifty-four had undergone temporal lobe resections and 16 extratemporal resections (12 frontal). A cross-sectional follow-up in the form of a semistructured interview was performed in late 2003. RESULTS: Mean follow-up was 12.4 years (range 8.6-16.2). Of the 70 patients (51% males), five (7%) were dead (three as a result of non-epilepsy related causes). Of the 65 patients interviewed, 38 (58%) were seizure-free at the long term follow-up: 65% of the patients with temporal lobe resections and 36% of the patients with extratemporal resections. Of the 35 patients who were seizure-free at the 2 year follow-up, 3 (9%) had seizures at the long term follow-up. Of the 30 patients who had seizures at the 2 year follow-up, 6 (20%) were seizure-free at the long term follow-up. Of all 65 patients, 45 (69%) had the same seizure status as the 2 year follow-up. Sixteen (25%) had an improved seizure status and 4 (6%) had a worsened status. Of the seizure-free patients, 11 (29%) had ceased taking AED, 28 (74%) were working and 25 (66%) had a driving license. CONCLUSIONS: Adult patients who are seizure-free 2 years after resective epilepsy surgery are most likely to still be seizure-free 10 years later. Most are working and have obtained a driving license.

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