Long term outcome in patients not initially seizure free after resective epilepsy surgery

Purpose: To assess the long-term seizure outcome and find predictors of outcome for patients who were not initially seizure free 6 months after epilepsy surgery. Methods: We retrospectively reviewed all adult patients who underwent epilepsy surgery at the Epilepsy Center Bethel, between 1992 and 2003. There were 266 patients included in this analysis. Results: Of the 266 patients who were included in this study, the probability of becoming seizure free was 12% (95%CI 8-16%) after 2 years, 19.5% (95%CI 15-24%) after 5 years and 34.7% (95%CI 28-41%) after 10 years. In patients who had auras only, the probability of being seizure free was 18.2% after 2 years, 25.5% after 5 years, and 39.1% after 10 years. In the multiregression analysis, the EEG carried out 2 years after surgery, a psychic aura, the frequency of postoperative focal seizures and hypermotor seizures predicted seizure remission in the long-term outcome. Conclusions: The frequency and type of postoperative seizures are critical determinants for long-term outcome. Seizure semiology may be the clue to a precise diagnosis and long-term prognosis of epilepsy. (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.