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Outcomes of multilobar resections for epilepsy in Sweden 1990-2013: a national population-based study
Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Epilepsy Res Grp, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Neurosurg, Bla Str 5,3 Tr, S-41345 Gothenburg, Sweden..
Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Epilepsy Res Grp, Gothenburg, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Clinical Neurophysiology.
Gothenburg Univ, Sahlgrenska Acad, Inst Neurosci & Physiol, Epilepsy Res Grp, Gothenburg, Sweden..
2016 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 158, no 6, 1151-1157 p.Article in journal (Refereed) PublishedText
Abstract [en]

Reports on outcome after multilobar resection (MLR) are scarce and most are retrospective single-centre studies or case studies with few patients. The aim of this study is to present seizure and complication outcomes 2 years after MLR in a prospective population-based series. The Swedish National Epilepsy Surgery Registry (SNESUR) provides prospective population-based data on outcome and complications after epilepsy surgery. For this study, we have analysed data on seizure outcome and complications after MLR from the SNESUR between 1990 and 2013. Fifty-seven patients underwent MLR; 40/57 surgeries were performed between 1990 and 2000. Sixteen operations were classified as partial hemispherotomy. Resections were right-sided in 33 (58 %) patients. Mean age was 17.3 years (range, 0.3-63.4 years) and mean duration of epilepsy before surgery was 11.0 years (range, 0.2-37 years). Preoperative neurological deficits were seen in 19 patients (33.3 %). Learning disability (LD) was seen in 18 patients (31.6 %), six had severe LD (IQ < 50). Seizure outcome after 2 years was available for 53 patients. Thirteen (24.5 %) were seizure-free and 12 (22.6 %) had > 75 % seizure frequency reduction. Three (5.3 %) patients suffered major complications: infarction of the middle cerebral artery, epidural abscess and hemiparesis. Minor complications were seen in ten patients. There was no mortality. This prospective, population-based study provides data on seizure outcome and complications after MLR. In selected patients MLR can be considered, but expectations for seizure freedom should not be too high and patients and parents should be counselled appropriately.

Place, publisher, year, edition, pages
2016. Vol. 158, no 6, 1151-1157 p.
Keyword [en]
Epilepsy surgery, Multilobar resection, Complications, Seizure outcome
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-298056DOI: 10.1007/s00701-016-2807-3ISI: 000376096900019PubMedID: 27106840OAI: oai:DiVA.org:uu-298056DiVA: diva2:946434
Available from: 2016-07-05 Created: 2016-06-29 Last updated: 2016-07-05Bibliographically approved

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