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Early seizures after temporal lobectomy predict subsequent seizure recurrence
Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in‐depth examination of early postoperative seizures (
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| Published in: | Annals of neurology 2005-02, Vol.57 (2), p.283-288 |
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| container_end_page | 288 |
| container_issue | 2 |
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| container_title | Annals of neurology |
| container_volume | 57 |
| creator | McIntosh, Anne M. Kalnins, Renate M. Mitchell, L. Anne Berkovic, Samuel F. |
| description | Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in‐depth examination of early postoperative seizures ( |
| doi_str_mv | 10.1002/ana.20372 |
| format | article |
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Anne ; Berkovic, Samuel F.</creator><creatorcontrib>McIntosh, Anne M. ; Kalnins, Renate M. ; Mitchell, L. Anne ; Berkovic, Samuel F.</creatorcontrib><description>Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in‐depth examination of early postoperative seizures (<28 days) and outcome. The risk of recurrence at one postoperative year was calculated using Poisson regression, and statistical adjustments were made for preoperative pathology. Of 321 patients, 69 (22%) experienced early postoperative seizures. These early seizures were associated with subsequent seizure recurrence (rate ratio [RR] 5.9; 95% confidence interval [CI], 4.1–8.4). Among patients with early seizures, the only significant factor was the presence of seizure precipitants, which was associated with a lower recurrence risk. However, when compared with patients with no early seizures, those with precipitants to early seizures had a higher risk of recurrence (RR, 3.0; 95% CI, 1.8–5.2). The risk was higher again for patients without precipitants to early seizures (RR, 7.6; 95% CI, 5.0–11.5). Early seizures and other seizure recurrences in the first postoperative year did not differ in their effect on subsequent outcome (X2 [3] = 3.4, p = 0.33). We conclude that early postoperative seizures are associated with subsequent seizure recurrence. These findings have implications for patient counseling and the measurement of outcome. Ann Neurol 2005;57:283–288</description><identifier>ISSN: 0364-5134</identifier><identifier>EISSN: 1531-8249</identifier><identifier>DOI: 10.1002/ana.20372</identifier><identifier>PMID: 15668930</identifier><identifier>CODEN: ANNED3</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Anterior Temporal Lobectomy ; Biological and medical sciences ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Epilepsy, Temporal Lobe - complications ; Epilepsy, Temporal Lobe - surgery ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Prognosis ; Recurrence ; Seizures - epidemiology ; Seizures - etiology ; Seizures - surgery ; Temporal Lobe - physiopathology ; Time Factors ; Treatment Outcome</subject><ispartof>Annals of neurology, 2005-02, Vol.57 (2), p.283-288</ispartof><rights>Copyright © 2005 American Neurological Association</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4222-121d323a4f253c39f0adb0e84f689aecc298f1b44dfa3e9122d837e8f37da3a13</citedby><cites>FETCH-LOGICAL-c4222-121d323a4f253c39f0adb0e84f689aecc298f1b44dfa3e9122d837e8f37da3a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16669494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15668930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McIntosh, Anne M.</creatorcontrib><creatorcontrib>Kalnins, Renate M.</creatorcontrib><creatorcontrib>Mitchell, L. Anne</creatorcontrib><creatorcontrib>Berkovic, Samuel F.</creatorcontrib><title>Early seizures after temporal lobectomy predict subsequent seizure recurrence</title><title>Annals of neurology</title><addtitle>Ann Neurol</addtitle><description>Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in‐depth examination of early postoperative seizures (<28 days) and outcome. The risk of recurrence at one postoperative year was calculated using Poisson regression, and statistical adjustments were made for preoperative pathology. Of 321 patients, 69 (22%) experienced early postoperative seizures. These early seizures were associated with subsequent seizure recurrence (rate ratio [RR] 5.9; 95% confidence interval [CI], 4.1–8.4). Among patients with early seizures, the only significant factor was the presence of seizure precipitants, which was associated with a lower recurrence risk. However, when compared with patients with no early seizures, those with precipitants to early seizures had a higher risk of recurrence (RR, 3.0; 95% CI, 1.8–5.2). The risk was higher again for patients without precipitants to early seizures (RR, 7.6; 95% CI, 5.0–11.5). Early seizures and other seizure recurrences in the first postoperative year did not differ in their effect on subsequent outcome (X2 [3] = 3.4, p = 0.33). We conclude that early postoperative seizures are associated with subsequent seizure recurrence. These findings have implications for patient counseling and the measurement of outcome. Ann Neurol 2005;57:283–288</description><subject>Anterior Temporal Lobectomy</subject><subject>Biological and medical sciences</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Epilepsy, Temporal Lobe - complications</subject><subject>Epilepsy, Temporal Lobe - surgery</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Seizures - epidemiology</subject><subject>Seizures - etiology</subject><subject>Seizures - surgery</subject><subject>Temporal Lobe - physiopathology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0364-5134</issn><issn>1531-8249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqF0E1P3DAQBmALFcECPfQPVLm0Ug8Bj-048XG1BYrElwSoR2vijKW0-djaiWD768l2FzhVnHx53pnxy9gn4MfAuTjBDo8Fl7nYYTPIJKSFUOYDm3GpVZqBVPvsIMZfnHOjge-xfci0LozkM3Z1iqFZJZHqv2OgmKAfKCQDtcs-YJM0fUlu6NtVsgxU1W5I4lhG-jNSN7yEkkBuDIE6R0ds12MT6eP2PWQPZ6f3ix_p5c35xWJ-mTolhEhBQCWFROVFJp00nmNVciqUn65Cck6YwkOpVOVRkgEhqkLmVHiZVygR5CH7upm7DP10SxxsW0dHTYMd9WO0OpdFbkC_C8FkRgFfw28b6EIfYyBvl6FuMawscLsu2U4l238lT_bzduhYtlS9yW2rE_iyBRgdNj5g5-r45rTWRhk1uZONe6wbWv1_o51fz19Wp5tEHQd6ek1g-L3-c57Zn9fn9iy_hdtFdme_y2cATqLE</recordid><startdate>200502</startdate><enddate>200502</enddate><creator>McIntosh, Anne M.</creator><creator>Kalnins, Renate M.</creator><creator>Mitchell, L. Anne</creator><creator>Berkovic, Samuel F.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Willey-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200502</creationdate><title>Early seizures after temporal lobectomy predict subsequent seizure recurrence</title><author>McIntosh, Anne M. ; Kalnins, Renate M. ; Mitchell, L. Anne ; Berkovic, Samuel F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4222-121d323a4f253c39f0adb0e84f689aecc298f1b44dfa3e9122d837e8f37da3a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Anterior Temporal Lobectomy</topic><topic>Biological and medical sciences</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Epilepsy, Temporal Lobe - complications</topic><topic>Epilepsy, Temporal Lobe - surgery</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>Seizures - epidemiology</topic><topic>Seizures - etiology</topic><topic>Seizures - surgery</topic><topic>Temporal Lobe - physiopathology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McIntosh, Anne M.</creatorcontrib><creatorcontrib>Kalnins, Renate M.</creatorcontrib><creatorcontrib>Mitchell, L. Anne</creatorcontrib><creatorcontrib>Berkovic, Samuel F.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McIntosh, Anne M.</au><au>Kalnins, Renate M.</au><au>Mitchell, L. Anne</au><au>Berkovic, Samuel F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early seizures after temporal lobectomy predict subsequent seizure recurrence</atitle><jtitle>Annals of neurology</jtitle><addtitle>Ann Neurol</addtitle><date>2005-02</date><risdate>2005</risdate><volume>57</volume><issue>2</issue><spage>283</spage><epage>288</epage><pages>283-288</pages><issn>0364-5134</issn><eissn>1531-8249</eissn><coden>ANNED3</coden><abstract>Patients are understandably anxious if seizures occur immediately after temporal lobectomy. Such “neighborhood” seizures are commonly regarded as irrelevant to seizure outcome and discounted in outcome measurement. We conducted an in‐depth examination of early postoperative seizures (<28 days) and outcome. The risk of recurrence at one postoperative year was calculated using Poisson regression, and statistical adjustments were made for preoperative pathology. Of 321 patients, 69 (22%) experienced early postoperative seizures. These early seizures were associated with subsequent seizure recurrence (rate ratio [RR] 5.9; 95% confidence interval [CI], 4.1–8.4). Among patients with early seizures, the only significant factor was the presence of seizure precipitants, which was associated with a lower recurrence risk. However, when compared with patients with no early seizures, those with precipitants to early seizures had a higher risk of recurrence (RR, 3.0; 95% CI, 1.8–5.2). The risk was higher again for patients without precipitants to early seizures (RR, 7.6; 95% CI, 5.0–11.5). Early seizures and other seizure recurrences in the first postoperative year did not differ in their effect on subsequent outcome (X2 [3] = 3.4, p = 0.33). We conclude that early postoperative seizures are associated with subsequent seizure recurrence. These findings have implications for patient counseling and the measurement of outcome. Ann Neurol 2005;57:283–288</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>15668930</pmid><doi>10.1002/ana.20372</doi><tpages>6</tpages></addata></record> |
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| subjects | Anterior Temporal Lobectomy Biological and medical sciences Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Epilepsy, Temporal Lobe - complications Epilepsy, Temporal Lobe - surgery Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Medical sciences Nervous system (semeiology, syndromes) Neurology Prognosis Recurrence Seizures - epidemiology Seizures - etiology Seizures - surgery Temporal Lobe - physiopathology Time Factors Treatment Outcome |
| title | Early seizures after temporal lobectomy predict subsequent seizure recurrence |
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