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Epilepsia ; 45(11): 1383-91, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15509239

RESUMO

PURPOSE: Surgical results in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS) are often reported in conjunction with other etiologies of TLE. METHODS: We prospectively collected surgical outcome data for 2 to 11 years for 134 consecutive patients who specifically had MTLE and unilateral HS, according to magnetic resonance imaging (MRI) and confirmed by histopathology. Sixty-five had postoperative neuropsychological testing. Outcome was analyzed by using Engel's classification (a) through Kaplan-Meier estimated survival curves (as a function of the time to seizure recurrence), (b) as percentage of patients in each outcome class on a yearly basis, and (c) at the last updated follow-up. RESULTS: Kaplan-Meier estimates of complete seizure freedom (Engel's class IA) for years 1, 2, 5, and 10 were 85%, 77%, 74%, and 66%, and of Engel's class I were 89%, 86%, 83%, and 81%. Only nine (6.7%) patients had outcome classes III or IV at any point during follow-up. Of the patients tested, 26% of those operated on the left side and 22% of those operated on the right had postoperative decline of >1 SD in verbal or visual memory, respectively. CONCLUSIONS: High rates of seizure freedom can be obtained and remain stable over the years in patients operated on for unilateral MTLE/HS, even in countries with limited resources.


Assuntos
Epilepsia do Lobo Temporal/cirurgia , Adolescente , Adulto , Idade de Início , Encefalopatias/diagnóstico por imagem , Encefalopatias/epidemiologia , Encefalopatias/patologia , Criança , Comorbidade , Estudos Transversais , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/epidemiologia , Feminino , Hipocampo/patologia , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Cintilografia , Esclerose , Análise de Sobrevida , Resultado do Tratamento
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