Abstracts

Rationale: Epilepsy is a highly prevalent disease, with 30% of patients being resistant to anti-epileptic drugs (AEDs). For these patients, epilepsy surgery is a safe and viable option for treatment, with between 50-80% of patients becoming seizure free after surgery. Still, only 1% of appropriate patients undergo surgery. To help address this disparity, the University of Kansas Comprehensive Epilepsy Center has recently restarted its surgical epilepsy program. Methods: A retrospective chart review from January 2013 until April 2017 was undertaken at the University of Kansas Medical Center to assess our patient demographics and surgical outcomes. This study was approved by the University of Kansas Medical Center Instutional Review Board. Results: 40 patients underwent 43 surgeries [29 resection, 14 laser interstitial thermal therapy (LITT)]. The number of surgical cases has increased each year since the program’s reinitiation. The average age of patients undergoing epilepsy surgery is 45 years and the average length of epilepsy prior to epilepsy surgery is 26 years. Monitoring with intracranial electrodes was done in 58% of the patients. 28 patients (%70) had temporal and 12 patients (30%) had extratemporal surgery with 68% seizure freedom rate after surgery. Of note, 50% (7 patients) of the patients achieved seizure freedom after LITT. Additional two patients who had failed LITT became seizure free after anterior temporal lobectomy.Regarding complications, one patient developed hemiparesis from a left internal capsule ischemic stroke, one patient developed sensory aphasia, and one patient developed intracranial hemorrhage. All other neurological complications were minor and temporary. Conclusions: Epilepsy surgery is an effective treatment for medically refractory epilepsy. Our findings suggest that outcomes from a recently reestablished center can be similar to outcomes from established centers. Restarting an epilepsy surgery program can be slow initially, but surgical volume growth can be expected with institutional support as well as increasing patient and physician awareness.