Drug-resistant epilepsy. Experience with surgical treatment at the Institute of Neurology and Neurosurgery, Havana, Cuba (2012-2018)
Keywords:
drug-resistant epilepsy, epilepsy surgery, epilepsy.Abstract
Introduction: Epilepsy is the most frequent neurological alteration in the general population. The objective of epilepsy surgery is to guarantee the absence or the decrease of seizures which is achieved in 67 % and 80 % of patients.
Objective: To evaluate the surgical outcome and the factors for good outcome in patients with drug-resistant epilepsy (DRE) who underwent surgical treatment at the Institute of Neurology and Neurosurgery.
Material and Methods: A retrospective prospective observational study was conducted at the Institute of Neurology and Neurosurgery between January 2012 and May 2018.
Results: Of all the patients studied, 44,8 % were between 21 and 30 years old, 62,1 % were male and 82,8 % were white. Also, 31 % were between 11 and 20 years of follow-up. Epilepsy was lesional in 75,9 % of patients whereas in 55,2 % of them it was located in the temporal lobe; clinical congruence was demonstrated in 86,2 % of patients. Resective techniques were used in 87,6 % of them. Besides, 82,8 % had no postoperative seizures. There were no complications in 62,1 % of patients. On the other hand, 55 and 82 % of the patients studied were classified as Engel Class I and Engel Class II at 3, 6 and 12 months after surgical intervention.
Conclusions: The use of resective techniques and the absence of seizures after surgery predominated in our study. No significant relationship was found between surgical outcome, etiology of epilepsy and clinical congruence. The presence of a focal lesion of the temporal lobe was a factor for good outcome.
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