Identification of common predictors of surgical outcomes for epilepsy surgery

Abstract

Although epilepsy surgery is an effective treatment for patients with drug-resistant epilepsy, surgical outcomes vary across patient groups and studies. Identification of reliable prognostic factors for surgical outcome is important for outcome research. In this study, recent systematic reviews and meta-analyses on prediction of seizure outcome have been analyzed and common predictors of seizure outcome or unrelated factors for temporal lobe epilepsy (TLE), lesion extra temporal lobe epilepsy (ETLE), and tuberous sclerosis complex have been identified. Clinical factors such as lesion epilepsy, abnormal magnetic resonance imaging, partial seizures, and complete resection were found to be common positive predictors, and factors such as non lesion epilepsy, poorly defend and localized epileptic focus, generalized seizures, and incomplete resection are common negative predictors, while factors such as age at surgery and side of surgery are unrelated to seizure outcome for TLE and lesion ETLE. In addition, diagnostic neuro imaging and resection are among the most important predictors of seizure outcome. However, common predictors of seizure outcome could not be identified in non lesion ETLE because no predictors were found to be significant in adult patients (by meta-analysis), and outcome prediction is difficult in this case. Meta-analysis of other outcomes, such as neuro psycho logic outcomes, is rare due to lack of evaluation standards. Further studies on identification of reliable predictors of surgical outcomes are needed. © 2013 Zhang et al.