Journal of Korean Neurosurgical Society

  • 제48권3호
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  • Pages.230-235
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Comparison between Initial and Recent Surgical Outcome of 15-Year Series of Surgically Remediable Epilepsy

  • Lee, Myoung-Hee (Department of Neurosurgery, Dongsan Epilepsy Center, Keimyung University School of Medicine) ;
  • Son, Eun-Ik (Department of Neurosurgery, Dongsan Epilepsy Center, Keimyung University School of Medicine)
  • 투고 : 2010.05.03
  • 심사 : 2010.09.17
  • 발행 : 2010.09.28
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초록

Objective : The aim of this study is to compare the surgical outcome of the initial and recent surgical cases, during our 15-years experience, in terms of the surgical strategies and the prognostic factors for surgically remediable epilepsy. Methods : We retrospectively reviewed and compared the surgical outcomes between the initial 256 (Group I) and recent 139 (Group II) patients according to the time period of operation for a total of 518 consecutive epilepsy surgeries at our institution since 1992. The patients of the middle intermediate period, which were subjected to changed surgical strategies, were excluded. Results : The surgical outcome data from the initial and recent groups showed a much improved outcome for patients who underwent temporal lobe epilepsy (TLE) surgery over time. The number of patients with a good outcome (Engel class I-II) was much increased from 87.7% (178 TLE cases of Group I) to 94.8% (79 TLE cases of Group II) and this was statistically significant (p = 0.0324) on univariate analysis. Other remarkable changes were the decreased performance of intracranial invasive studies from 43.5% in Group I to 30.9% in Group II due to the advanced neuroimaging tools. The strip/grid ratio was reduced from 131/32 in Group I to 17/25 in Group II, because of a markedly reduced mesial TLE surgery and an increased extratemporal epilepsy surgery. Conclusion : Our results show that surgical outcome of epilepsy surgery has improved over time and it has shown to be efficient to control medically intractable epilepsy. Appropriate patient selection, comprehensive preoperative assessments and more extensive resection are associated with good postoperative outcomes.

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참고문헌

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피인용 문헌

  1. Neuropathology in patients with multiple surgeries for medically intractable epilepsy vol.16, pp.6, 2010, https://doi.org/10.1016/j.anndiagpath.2012.03.007
  2. Emerging Surgical Strategies of Intractable Frontal Lobe Epilepsy with Cortical Dysplasia in Terms of Extent of Resection vol.56, pp.3, 2014, https://doi.org/10.3340/jkns.2014.56.3.248
  3. Spectrum of neurosurgeon's role in epilepsy surgery vol.39, pp.3, 2010, https://doi.org/10.1016/j.bj.2016.01.009
  4. Outcome of lesional epilepsy surgery : Report of the first comprehensive epilepsy program in Iran vol.9, pp.4, 2010, https://doi.org/10.1212/cpj.0000000000000627