Is the Outcome after Surgery Worse in HS Patients with Additional Microscopic Dysplasia?
Abstract number :
2.290
Submission category :
Year :
2001
Submission ID :
1201
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
R.M. Kalnins, FRCPA, Anatomical Pathology, Austin and Repatriation Medical Campus, Heidelberg, Victoria, Australia; R.S. Briellmann, MD, Neurosciences Building, Brain Research Institute, Heidelberg, Victoria, Australia; A.M. McIntosh, Dip Epid Biostat, Ne
RATIONALE: Refractory temporal lobe epilepsy with hippocampal sclerosis (HS) usually has an excellent outcome after temporal lobectomy. However, macroscopic dysplastic lesions may be associated with seizure recurrence. Here we investigate whether presence of mesial microscopic dysplasia (MD) has an adverse effect on surgical outcome of HS patients.
METHODS: Temporal lobe tissue of 125 HS patients (mean age at operation 35 years, 64 females) was histologically assessed. Antecedents, seizure characteristics and outcome (based on the Engel classification, ref) was compared between HS patients with and without mesial MD.
RESULTS: Mesial MD was found in 52 (42%) of the 125 HS patients. Presence and type of antecedents, onset of habitual seizures, and severity of the epilepsy was not different between HS with and without MD. Outcome was not dependent on the presence of MD: excellent outcome (Engel Class 1) was present in 74% of those with MD and in 78% of those without MD, and a moderate outcome (Engel Class 2-4) was present in 26% of those with MD and in 22% of those without MD.
CONCLUSIONS: Mesial MD is common in HS. However, there is no suggestion that it is associated with a worse outcome after surgery.
Ref: Engel, J.J., Outcome with respect to seizures, in Surgical treatment of the epilepsies, J.J. Engel, Editor. 1987, Raven Press: New York. p. 553-571.