207 | Multidimensional Evaluation of Surgery for Epilepsy: Longitudinal Study in a Public Hospital

Disorders of the Nervous System

Author: Manuela Maria Villanueva | Email: manuelamaria.villanueva@gmail.com

Manuela Villanueva , Florencia Andrieu , Yankowyez Fernanda , Silvia Oddo , Nuria Campora , Exequiel Verder , Pablo Seoane , Juan Pablo Princich , Brenda Giagante , Silvia Kochen

1° ENyS

In the cohort of 111 evaluated patients, the current mean age was 38 years (SD: 10), with 53% being female. The mean age at the time of surgery was 33 years (SD: 10), with a median of 10 seizures per month (mean of 21 with SD of 28). The average duration of epilepsy was 21 years (SD: 12), and the average age of onset was 13 years (SD: 9). Patients had an average of 3 previous antiepileptic medications before surgery (SD: 1). Perinatal antecedents were observed in 5%, while febrile seizures affected 21%, meningitis 9%, and family history of epilepsy or febrile seizures 6%.
Regarding the types of surgery, 80% corresponded to anterior temporal lobectomies + amygdalohippocampectomy (ATL + AH), 5% to ATL + AH + extratemporal surgery, and 14% to extratemporal procedures. Left lateralization was present in 59% of patients. Magnetic resonance imaging (MRI) was performed in all patients, with 93% of cases showing lesions. Additionally, 100% of patients underwent Video-EEG, 17% underwent positron emission tomography (PET) (of which 14% were pathological), 23% underwent Stereoelectroencephalography (SEEG), and 8% underwent functional MRI. Pathological anatomies revealed that 68% corresponded to hippocampal sclerosis (HS), 16% to Focal Cortical Dysplasia (FCD) (ILAE type 1 or 2), 5% to cavernomas, 3% to gliomas, 1% to Dysembryoplastic Neuroepithelial Tumor (DNET), and 6% to uncharacteristic findings. The analysis was conducted at an average of 4.29 years post-surgery.