Long-term Outcome of Resective Epilepsy Surgery in Patients With Lennox-Gastaut Syndrome
- Authors
- Kang, Joon Won; Eom, Soyong; Hong, William; Kwon, Hye Eun; Park, Soyoung; Ko, Ara; Kang, Hoon-Chul; Lee, Joon Soo; Lee, Young-Mock; Kim, Dong Seok; Kim, Heung Dong
- Issue Date
- Oct-2018
- Publisher
- American Academy of Pediatrics
- Keywords
- 소아과학
- Citation
- Pediatrics, v.142, no.4
- Journal Title
- Pediatrics
- Volume
- 142
- Number
- 4
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/5600
- DOI
- 10.1542/peds.2018-0449
- ISSN
- 0031-4005
1098-4275
- 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.
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