Surgical Outcome of Pharmaco Refractory Epilepsy in the National Epilepsy Center of Sri Lanka

The National Epilepsy Center (NEC) in Sri Lanka was established in 2017. Seizure outcome, effects on quality of life (QOL) and surgical complications among nonpediatric patients who underwent epilepsy surgery from October 2017 to February 2023 are described. Nineteen patients (≥14 years) underwent e...

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Bibliographic Details
Published in:World neurosurgery 2024-04, Vol.184, p.e494-e502
Main Authors: Ranasinghe, K.M.I.U., Senanayake, Sunethra, Gunasekara, Sudath, Garusinghe, Sanjeewa, Attanayake, Deepal, Wanigasinghe, Jithangi, Fernando, Sanjaya, Kudavidanage, Bimal, de Silva, Anil, Suraweera, Chathurie, Satharasinghe, Sachintha, Karunanayaka, Salika, Senanayake, Sameera Jayan, Gooneratne, Inuka Kishara
Format: Article
Language:English
Subjects:
Epilepsy surgery
Epilepsy surgery quality of life
Epilepsy surgery seizure outcomes
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Summary:The National Epilepsy Center (NEC) in Sri Lanka was established in 2017. Seizure outcome, effects on quality of life (QOL) and surgical complications among nonpediatric patients who underwent epilepsy surgery from October 2017 to February 2023 are described. Nineteen patients (≥14 years) underwent epilepsy surgery at the NEC. We used Engel classification and Quality of Life in Epilepsy 31 (QOLIE-31) questionnaire to assess seizure outcome and QOL respectively. Surgical complications were categorized into neurological and complications related to surgery. Nine female and 10 male patients underwent surgery (mean age 27.5 years (range 14–44 years). The mean follow-up duration was 10.5 months (range 6–55 months). Twelve patients underwent temporal lobe resections. At 6-months follow-up, 83.3% (10/12) had favorable seizure outcomes with Engel class I/II. At 1-year follow-up 6/8 patients (75.0%) and at 2-year follow-up, 5/7 patients (71.4%) had a favorable outcome. Seven patients had extra-temporal lobe surgeries and one defaulted. Seizure freedom was observed in 6/6 at 6 months, 3/3 at 1-year, and 2/2 at 2-year follow-up. Five patients (26.3%) experienced minor post-operative surgical site infection. Two (11.1%) had persistent quadrantanopia. Meaningful improvement in QOL (change in QOLIE-31 score ≥11.8) was observed irrespective of seizure outcome or type of surgery (P 
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2024.01.153