Changing Global Trends in Seizure Outcomes Following Resective Surgery for Tuberous Sclerosis in Children with Medically Intractable Epilepsy. (25th November 2012)

• Record Type: Journal Article
• Authors: Ibrahim, George M.; Fallah, Aria; Carter Snead, O.; Rutka, James T.
• Other Names: Albaradie Raidah S. Academic Editor.
• Is Part Of: Epilepsy research and treatment. Volume 2012(2012)
• Publication Date: 2012-11-25
• Subjects: Brain -- Diseases -- Periodicals; Epilepsy -- Periodicals; Neurology -- Periodicals; Brain Diseases; Epilepsy; Neurology; Brain -- Diseases; Epilepsy; Neurology; Brain Diseases -- Periodicals; Brain -- Diseases -- Periodicals; Epilepsy -- Periodicals; Neurology -- Periodicals; Electronic journals; Periodical; Periodicals; Fulltext; Internet Resources; Periodicals; 616.853
• DOI: 10.1155/2012/135364
• Languages: English
• ISSNs: 2090-1348

Abstract

Abstract : Introduction . Tuberous sclerosis (TS) is the leading cause of genetic epilepsy worldwide. Here, we evaluate changes in seizure outcomes following resective epilepsy surgery in children with TS over time. Methods . A systematic review of the literature was performed to identify studies reporting seizure outcomes following resective epilepsy surgery in children with TS. Using an individual participant meta-analysis approach, seizure outcomes and associated covariates were combined. Multivariate logistic regression was used to determine significant associations between seizure outcomes and time of surgery. Results . Twenty studies from 1966 to present, yielding 186 participants, met the inclusion criteria for the study. On univariate analysis, there was a significant improvement in seizure outcomes in children who underwent resective epilepsy surgery within the last 15 years compared to older cohorts (chi-square 4.1; P = 0.043 ). On multivariate analysis, adjusting for length of followup, this trend was not significant (OR 0.52; 95% CI 0.23–1.17; P = 0.11 ). In the last 15 years, a greater proportion of younger children also underwent resective surgery compared to older cohorts (OR 0.93; 95% CI 0.89–0.97; P < 0.01 ). Conclusions . A trend towards improved seizure outcomes following resective surgery for TS was observed from 1966 to present on multivariate analysis.