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Efficacy of the Danish epilepsy surgery programme

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DOI

  • E Holm, Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 28 Juliane Maries Vej, 3rd Floor, Building 6931, DK-2100 Copenhagen, Denmark.
  • ,
  • M T Foged, Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 28 Juliane Maries Vej, 3rd Floor, Building 6931, DK-2100 Copenhagen, Denmark.
  • ,
  • S Beniczky
  • B Jespersen, Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, 7 Inge Lehmanns Vej, 9.th Floor, Entrance 2, DK-2100 Copenhagen, Denmark.
  • ,
  • J Brennum, Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, 7 Inge Lehmanns Vej, 9.th Floor, Entrance 2, DK-2100 Copenhagen, Denmark.
  • ,
  • L H Pinborg, The Epilepsy Clinic, Department of Neurology, University State Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark. Electronic address: anne.sabers@regionh.dk.

OBJECTIVE: Despite optimal medical treatment, approximately one-third of patients with epilepsy continue to have seizures. Epilepsy surgery is widely accepted as a therapeutic option in the selected subset of patients with drug-resistant focal epilepsy. Here, we report the results of the Danish epilepsy surgery programme from 2009 to 2014.

MATERIAL AND METHODS: A total of 169 consecutive patients, operated at Rigshospitalet, were included. Information was gathered from digital patient records. Before 1-year follow-up, two patients were lost to follow-up and three were referred to new surgery.

RESULTS: The median years of drug resistance before operation were 11 years. At 1-year follow-up (n = 164), seizure outcomes were as follows: 65% Engel I (free from disabling seizures), 51% Engel IA (completely seizure free) and 9% Engel IV (no worthwhile improvement), and for patients operated in the medial temporal lobe (n = 114): 70% Engel I, 56% Engel IA, 5% Engel IV. The outcomes of the 53 patients needing intracranial EEG recording (ICR) were not significantly different from the patients only evaluated with surface EEG. None of the eight MRI-negative patients operated outside the medial temporal lobe after ICR were free of disabling seizures. 12% of MTLE patients developed de novo depression after epilepsy surgery despite good surgical outcome. Three patients required rehabilitation due to post-operative hemiplegia.

CONCLUSION: The outcomes of the Danish epilepsy surgery programme align with international results found in recent meta-analyses. Serious complications to epilepsy surgery are seldom. In accordance with international recommendations, Danish drug-resistant patients should be referred to epilepsy surgery evaluation at an earlier stage of the disease.

Original languageEnglish
Book seriesActa Neurologica Scandinavica. Supplementum
Volume137
Issue2
Pages (from-to)245-251
Number of pages7
ISSN0065-1427
DOIs
Publication statusPublished - Feb 2018

    Research areas

  • Journal Article

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