Authors :
Presenting Author: Richa Budhiraja, MBBS – Vanderbilt University Medical Center
Barbara Kwiecinska, MD – Vanderbilt University Medical Center
Randip Taneja, MD – Vanderbilt University Medical Center
Kevin Haas, MD, PhD – Vanderbilt University Medical Center
Angela Crudele, MD – Vanderbilt University Medical Center
Bassel Abou-Khalil, MD – Vanderbilt University Medical Center
Rationale:
Family history of epilepsy in a first degree relative may suggest a genetic predisposition with more diffuse seizure tendency. This could theoretically affect the efficacy of focal resection. We investigated the effect of strong family history of epilepsy on surgical outcome by analyzing the 2-year outcome in patients with temporal lobe epilepsy in relation to family history of epilepsy.
Methods:
We compared seizure outcome two years after temporal lobe epilepsy surgery (most commonly selective amygdalohippocampectomy and temporal lobectomy) in 338 patients, including two groups: a group who had first degree relatives with epilepsy and a group with no family history of epilepsy. Surgical outcome was based on the Engel outcome classification. We considered Engel class 1 and 2 outcomes as favorable. We used Chi square for group comparisons. Results:
Among 275 patients with no family history of epilepsy, 183 (66.5%) had Engel class 1 outcome and 46 (17%) had Engel class 2 outcome, with an overall favorable outcome of 83.5%. The remaining 46 patients had class 3 (27 patients) or class 4 (19 patients) outcome. Among 63 patients with first degree relatives with epilepsy, 40 (63.5%) had Engel class 1 outcome and 15 (24%) had Engel class 2 outcome, for an overall favorable outcome of 87%. The remaining 8 patients had class 3 (4 patients) and class 4 (4 patients) outcome. There was no significant difference between the two groups. There was also no difference between the two groups considering patients who underwent temporal lobectomy or patients who underwent selective amygdalohippocampectomy (Table).
Conclusions:
Having a first degree relative with epilepsy does not influence outcome after temporal lobe epilepsy surgery, regardless of surgery type (temporal lobectomy or selective amygdalohippocampectomy).
Funding: None