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Long-term Outcome of Resective Epilepsy Surgery in Patients With Lennox-Gastaut Syndrome

Authors
 Joon Won Kang  ;  Soyong Eom  ;  William Hong  ;  Hye Eun Kwon  ;  Soyoung Park  ;  Ara Ko  ;  Hoon-Chul Kang  ;  Joon Soo Lee  ;  Young-Mock Lee  ;  Dong Seok Kim  ;  Heung Dong Kim 
Citation
 Pediatrics, Vol.142(4) : e20180449, 2018 
Journal Title
 Pediatrics 
ISSN
 0031-4005 
Issue Date
2018
Abstract
OBJECTIVE: We aimed to evaluate the long-term outcome of resective epilepsy surgery in patients with Lennox-Gastaut syndrome (LGS). METHODS: We reviewed the case reports of 90 patients with LGS who had undergone resective surgery between 2003 and 2014 at the Severance Children's Hospital and managed them for a minimum period of 2 years. RESULTS: At the time of surgery, the patients were between 3.0 and 23.5 years old (mean ± SD: 9.3 ± 4.4). The time from seizure onset to surgery ranged from 0.7 to 20.1 years (7.2 ± 4.3). On postoperative follow-up for an average period of 6.1 ± 2.2 years (range: 2.1-11.4 years), 45 patients (50.0%) had no seizures, and 15 (16.7%) reported infrequent seizures. Seizure-free outcomes were achieved in 15 of the 21 (71.4%) hemispherectomies, 23 of the 51 (45.1%) multilobar resections, and 7 of the 18 (38.9%) single lobar resections. On high-resolution MRIs, 20 patients (22.2%) had negative findings, 8 of whom (40.0%) became seizure-free after resective surgery. Malformation of cortical development was the most common pathologic finding and was noted in 57 patients (63.3%). Seizure-free patients achieved better adaptive behavior and social competence than did patients with persistent seizures at the second (2-3 years after surgery) and third (4-6 years after surgery) follow-ups, as indicated by social quotients (P < .05). CONCLUSIONS: Resective surgery is a viable option in some patients to treat seizures that are associated with LGS, with a high probability of seizure control and better adaptive function.
Full Text
http://pediatrics.aappublications.org/content/142/4/e20180449.long
DOI
10.1542/peds.2018-0449
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Epilepsy Research Institute (뇌전증연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
강훈철(Kang, Hoon Chul) ORCID logo https://orcid.org/0000-0002-3659-8847
김동석(Kim, Dong Seok)
김흥동(Kim, Heung Dong) ORCID logo https://orcid.org/0000-0002-8031-7336
엄소용(Eom, So Yong)
이영목(Lee, Young Mock) ORCID logo https://orcid.org/0000-0002-5838-249X
이준수(Lee, Joon Soo) ORCID logo https://orcid.org/0000-0001-9036-9343
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166986
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