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Curative Surgery for Epileptic Spasms

Which procedures produce the best outcomes?

Publish date:: November 11, 2015

Curative epilepsy surgery in patients with epileptic spasms (ES), with or without history of infantile spasms, is best accomplished at an early age and in patients with lesional abnormalities on MRI with electroencephalography (EEG) concordance. This according to a study of 65 patients with ES who underwent surgery. Researchers’ findings included:

• Mean age at surgery was 5.1.

• Mean number of anticonvulsants used preoperatively was 4.2, which decreased to 1.2 postoperatively.

• Total hemispherectomy was the most commonly performed surgery (n=20), followed by subtotal hemispherectomy (n=17), multilobar resection (n=13), lobectomy (n=7), tuberectomy (n=6), and lobectomy + tuberectomy (n=2), with ILAE class I outcome in 20, 10, 7, 6, 3, 0 patients, respectively.

• Shorter duration of epilepsy and presence of MRI lesion were independently associated with class I outcome.

Citation: Chugani HT, Ilyas M, Kumar A, et al. Surgical treatment for refractory epileptic spasms: The Detroit series. [Published online ahead of print November 2, 2015]. Epilepsia. doi: 10.1111/epi.13221.

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