Two-Year Follow-up Outcomes of Non-lesional Epilepsy Surgery in Iran
| Author | Shakila Meshkat | en |
| Author | Vajiheh Aghamollaii | en |
| Author | Atefeh Behkar | en |
| Author | Arshia Zardoui | en |
| Author | Mojtaba Shahbazi | en |
| Author | Abbas Tafakhori | en |
| Orcid | Vajiheh Aghamollaii [0000-0002-1704-323X] | en |
| Orcid | Abbas Tafakhori [0000-0002-9835-0812] | en |
| Issued Date | 2024-07-31 | en |
| Abstract | Background: Despite treatment with anti-epileptic drugs, 30% of epileptic patients continue to experience seizures, making surgery a viable option. Surgery has shown efficacy even in non-lesional epileptic individuals, although there is limited research on this topic. Objectives: This study aimed to investigate surgical outcomes in individuals with drug-resistant epilepsy (DRE) who undergo surgery despite having non-lesional magnetic resonance imaging (MRI) findings. Methods: This observational longitudinal study was conducted between 2017 and 2020 at a referral hospital in Tehran, Iran. Using census sampling, we screened 750 epilepsy cases and enrolled 80 patients (42 women and 38 men) with DRE and non-lesional MRI findings who underwent epilepsy surgery. We collected patients' demographics and seizure characteristics. A 2-year follow-up was conducted to assess the seizure freedom rate. We compared seizure-free and non-seizure-free patients who underwent temporal epilepsy surgery, extratemporal epilepsy surgery, corpus callosotomy, and Vagus nerve stimulation (VNS) using chi-square, Fisher exact, and binary logistic regression tests. Results: The seizure freedom rate was 62.7% for temporal surgery, 83.33% for extratemporal surgery, 26.66% for corpus callosotomy, and none for patients who underwent VNS. There was no difference between seizure-free and non-seizure-free patients in terms of their baseline characteristics, seizure semiology, lesion features, and post-operative findings (P-values > 0.05), except that patients without a history of febrile convulsions tended to experience more seizure freedom after extratemporal surgery (P = 0.007). Additionally, older patients tended to experience more seizure freedom after temporal surgery (P = 0.03). Conclusions: This study underscores the potential benefits of epilepsy surgery in non-lesional DRE patients. Further research is needed to establish criteria for patient selection in this context. | en |
| DOI | https://doi.org/10.5812/ans-145454 | en |
| Keyword | Epilepsy | en |
| Keyword | Epilepsy Surgery | en |
| Keyword | MRI | en |
| Keyword | Drug Resistant Epilepsy | en |
| Keyword | Extratemporal Surgery | en |
| Publisher | Brieflands | en |
| Title | Two-Year Follow-up Outcomes of Non-lesional Epilepsy Surgery in Iran | en |
| Type | Research Article | en |
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