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Focal to bilateral motor seizures in temporal lobe epilepsy during video-EEG monitoring: effects on surgical outcome.

Authors
  • Kovačević, Maša1
  • Sokić, Dragoslav2, 3
  • Ristić, Aleksandar J2, 3
  • Baščarević, Vladimir3, 4
  • Đukić, Tijana2
  • Pejović, Aleksa2
  • Vojvodić, Nikola2, 3
  • 1 Neurology Clinic, Clinical Center of Serbia, Dr. Subotić Street 6, 11 000, Belgrade, Serbia. [email protected] , (Serbia)
  • 2 Neurology Clinic, Clinical Center of Serbia, Dr. Subotić Street 6, 11 000, Belgrade, Serbia. , (Serbia)
  • 3 Faculty of Medicine, University of Belgrade, Dr. Subotić Street 8, 11 000, Belgrade, Serbia. , (Serbia)
  • 4 Clinic for Neurosurgery, Clinical Center of Serbia, Kosta Todorović Street 4, 11 000, Belgrade, Serbia. , (Serbia)
Type
Published Article
Journal
Acta Neurologica Belgica
Publisher
Springer-Verlag
Publication Date
Dec 01, 2021
Volume
121
Issue
6
Pages
1677–1684
Identifiers
DOI: 10.1007/s13760-020-01471-7
PMID: 32813146
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of this study was to determine whether the occurrence of focal to bilateral motor seizures in the course of partial drug withdrawal during video-EEG monitoring (FTBMS-M) had a predictive value for seizure recurrence in surgically treated patients with mesial temporal lobe epilepsy (MTLE). We analyzed the outcomes of 59 patients who underwent temporal lobe resection at 12 month postoperative follow up. In total, 48 out of 59 patients were rendered seizure free (81.4%). We analyzed seizure recurrence after surgery with reference to: (i) occurrence of seizures after partial drug withdrawal during video-EEG monitoring (FTBMS-M); (ii) history of secondarily generalized seizures during antiepileptic drug treatment prior to presurgical evaluation (FTBMS-H) and (iii) other possible confounding factors (sex, age, epilepsy duration, side of surgery, presence of hippocampal sclerosis, and history of febrile seizures). We found no differences in the frequency of seizure recurrences between patients with FTBMS-M and patients without FTBMS-M (4/20 vs. 7/39; p = 0.848). Conversely, the frequency of seizure recurrence was significantly higher among the patients with FTBMS-H than among the patients without FTBMS-H (7/20 vs. 4/39; p = 0.021). The predictive value of FTBMS-H for postoperative seizure recurrence was confirmed in logistic regression analysis. We found a statistically significant influence of FTBMS-H on poor outcome after surgery, but not of FTBMS-M or other confounding variables, which suggests that withdrawal seizures do not affect postsurgical seizure control. © 2020. Belgian Neurological Society.

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