Patient Historical Risk Factors Associated with Seizure Outcome After Surgery for Drug-Resistant Nonlesional Temporal Lobe Epilepsy

Abstract

To investigate the possible influence of risk factors on seizure outcome after surgery for drug-resistant nonlesional temporal lobe epilepsy (TLE). This retrospective study recruited patients with drug-resistant nonlesional TLE who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center and werefollowed for a minimum of 1 year. Patients had beenprospectively registered in a database from 1991 to 2014. Postsurgical outcome was classified into 2 groups: seizure free or relapsed. The possible risk factors influencing long-term seizure outcome after surgery were investigated. Ninety-five patients (42 males and 53 females) were studied. Fifty-four (56.8%) patients were seizure free. Only a history of febrile seizure in childhood affected the risk of postoperative seizure recurrence (odds ratio, 0.22; 95% confidence interval, 0.06-0.83; P= 0.02). Gender, race, family history of epilepsy, history of status epilepticus, duration of disease before surgery, aura symptoms, IQ, and seizure type or frequency were not predictors of outcome. Many patients with drug-resistant nonlesional TLE responded favorably to surgery. The only factor predictive of seizure outcome after surgery was a history of febrile seizure in childhood. It is critical to distinguish among different types of TLE when assessing outcome after surgery.