Analysis of long-term surgical outcome and safety in patients with post-traumatic epilepsy / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the long-term surgical outcome and safety of resective surgical treatment in patients with post-traumatic epilepsy(PTE). Methods Patients with PTE who underwent resective surgery from January 2014 to December 2020 at our center were consecutively included,and their demographic characteristics and clinical data were retrospectively analyzed. Univariate analysis and multifactor Logistic regression analysis were used to identify potential predictors of postoperative outcome,and surgery-related complications were documented and followed-up. Results A total of 104 patients with PTE were included. The postoperative outcomes were graded by Engel class:60.6%(63/104) as Engel class Ⅰ and 39.4%(41/104) as Engel class Ⅱ-Ⅳ with a mean follow-up of(68.7±23.2) months(20-103 months). Univariate analysis showed that age at the time of surgery and surgical side were associated with postoperative outcome,while multivariate analysis showed that only surgical side was an independent predictor of postoperative outcome(OR=2.944,95%CI 1.283-6.753,P=0.011),with 2.9 times the seizure-free(Engel class Ⅰ) rate when the surgical side was right-sided compared with left-sided. 29.8%(31/104) of patients had varying degrees of surgery-related complications,including 20 cases of subcutaneous or subdural effusion;3 cases of cerebral edema;2 cases of cerebral hemorrhage;1 case of hydrocephalus combined with incisional infection;and 5 cases of neurological deficits,4 of which recovered completely during the follow-up period. Conclusion PTE patients treated with resective surgery after comprehensive preoperative evaluation had good long-term surgical outcomes and safety,and good postoperative outcomes were predicted when the surgical side was right-sided.