Analysis of the curative effect and predictive factors of frontal lobe epilepsy after surgery_Journal of Epilepsy

Authors：

HE Wenbin , ZHAO Mingrui , SHEN Yunjuan , LIU Yali , SHI Xuefeng , SHI Zhe , WANG Xiaoqiang , YANG Wenzhen , LAN Zhengbo , HAN Yanming ,  ZHANG Xinding

Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital; Institute of Neurology, Lanzhou University, Lanzhou 730030, China;

Corresponding author：

ZHANG Xinding, Email: zhangxind@lzu.edu.cn

Keywords：

Frontal lobe epilepsy; Surgical treatment; Prognosis; Predictive factors

DOI：

10.7507/2096-0247.20210036

Video：

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Objective To explore the long-term seizure outcome and prognostic factors of patients with frontal lobe epilepsy after surgery, so as to guide the evaluation of treatment and provide clinical reference.Methods This study retrospectively analyzed the clinical data of patients with frontal lobe epilepsy undergoing surgical treatment by multimodal epilepsy surgical evaluation system in the functional neurosurgery of the Second Hospital of Lanzhou University from January 2016 to February 2020, there were 17 males and 13 females, the age of onset of epileptic seizures was (16.30±10.65) years, the age at the time of surgical treatment was (23.98±11.04) years, and the duration of seizures was (7.68±6.37) years. The multimodal epilepsy surgical evaluation system includes phase I non-invasive evaluation and phase II invasive evaluation. The collected research variables were analyzed by descriptive statistics and multivariate logistic regression analysis to evaluate the importance of each research variable to the prognosis of epilepsy surgery, and to determine the potential prognostic factors, so as to explore the epilepsy control situation of patients with frontal lobe epilepsy after surgery and the influence of each variable that may affect the prognosis of epilepsy on the prognosis.Results The analysis of the clinical data of 30 patients with frontal lobe epilepsy showed that the good prognosis rate after FLE surgery (Engel I) was 70%, and the average follow-up was (29.9±14.1) months. The results of multivariate logistic regression analysis showed that the duration of epilepsy, the frequency of seizures, the presence or absence of stereotactic EEG (SEEG) monitoring, whether the lesion was completely removed, and whether acute postoperative seizures occurred were independent predictors of prognosis (P<0.05).Conclusion This study found that the long duration of epilepsy, frequent seizures, and postoperative acute seizures are significantly related to poor prognosis. The application of SEEG and complete resection of epileptic lesions can significantly improve the prognosis of FLE surgery.

Citation： HE Wenbin, ZHAO Mingrui, SHEN Yunjuan, LIU Yali, SHI Xuefeng, SHI Zhe, WANG Xiaoqiang, YANG Wenzhen, LAN Zhengbo, HAN Yanming, ZHANG Xinding. Analysis of the curative effect and predictive factors of frontal lobe epilepsy after surgery. Journal of Epilepsy, 2021, 7(3): 234-240. doi: 10.7507/2096-0247.20210036 Copy

1.	Pinheiro-Martins AP, Bianchin MM, Velasco TR, et al. Independent predictors and a prognostic model for surgical outcome in refractory frontal lobe epilepsy. Epilepsy Res, 2012, 99(1-2): 55-63.
2.	Barot N. Networks in Frontal Lobe Epilepsy. Neurosurg Clin N Am, 2020, 31(3): 319-324.
3.	Englot DJ, Wang DD, Rolston JD, et al. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis. J Neurosurg, 2012, 116(5): 1042-1048.
4.	Xu C, Yu T, Zhang G, et al. Prognostic Factors and Longitudinal Change in Long-Term Outcome of Frontal Lobe Epilepsy Surgery. World Neurosurg, 2019, 121: e32-e38.
5.	Simasathien T, Vadera S, Najm I, et al. Improved outcomes with earlier surgery for intractable frontal lobe epilepsy. Annals of Neurology, 2013, 73(5): 646-654.
6.	Samuel PJ, Menon RN, Chandran A, et al. Seizure outcome and its predictors after frontal lobe epilepsy surgery. Acta Neurol Scand, 2019, 140(4): 259-267.
7.	Ramantani G, Kadish NE, Mayer H, et al. Frontal lobe epilepsy surgery in children and adolescence: predictors of long term seizure freedom, overall cognitive and adaptive functioning. Neurosurgery, 2018, 83(2): 217-225.
8.	Kleen JK, Wu EX, Holmes GL, et al. Lenck‐Santini PP Enhanced oscillatory activity in the hippocampal‐prefrontal network is related to short‐term memory function after early‐life seizures. J Neurosci, 2011, 31(43): 15397-15406.
9.	Lin H, Holmes GL, Kubie JL, et al. Recurrent seizures induce a reversible impairment in a spatial hidden goal task. Hippocampus, 2009, 19: 817-827.
10.	Elsharkawy AE, Alabbasi AH, Pannek H, et al. Outcome of frontal lobe epilepsy surgery in adults. Epilepsy Res, 2008, 81(2-3): 97-106.
11.	Francesca B, Aileen MG, Didier S, et al. Predictive factors of surgical outcome in frontal lobe epilepsy explored with stereoelectroencephalography. Neurosurgery, 2018, 83(2): 217-225.
12.	Tigaran S, Cascino GD, McClelland RL, et al. Acute postoperative seizures after frontal lobe cortical resection for intractable partial epilepsy. Epilepsia, 2003, 44(41): 831-835.
13.	张弨, 胡文瀚, 王秀, 等. 额叶癫痫简单运动症状和复杂运动症状临床特点及癫痫传播网络的研究. 临床神经外科杂志, 2020, 17(2): 145-149.

1. Pinheiro-Martins AP, Bianchin MM, Velasco TR, et al. Independent predictors and a prognostic model for surgical outcome in refractory frontal lobe epilepsy. Epilepsy Res, 2012, 99(1-2): 55-63.
2. Barot N. Networks in Frontal Lobe Epilepsy. Neurosurg Clin N Am, 2020, 31(3): 319-324.
3. Englot DJ, Wang DD, Rolston JD, et al. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis. J Neurosurg, 2012, 116(5): 1042-1048.
4. Xu C, Yu T, Zhang G, et al. Prognostic Factors and Longitudinal Change in Long-Term Outcome of Frontal Lobe Epilepsy Surgery. World Neurosurg, 2019, 121: e32-e38.
5. Simasathien T, Vadera S, Najm I, et al. Improved outcomes with earlier surgery for intractable frontal lobe epilepsy. Annals of Neurology, 2013, 73(5): 646-654.
6. Samuel PJ, Menon RN, Chandran A, et al. Seizure outcome and its predictors after frontal lobe epilepsy surgery. Acta Neurol Scand, 2019, 140(4): 259-267.
7. Ramantani G, Kadish NE, Mayer H, et al. Frontal lobe epilepsy surgery in children and adolescence: predictors of long term seizure freedom, overall cognitive and adaptive functioning. Neurosurgery, 2018, 83(2): 217-225.
8. Kleen JK, Wu EX, Holmes GL, et al. Lenck‐Santini PP Enhanced oscillatory activity in the hippocampal‐prefrontal network is related to short‐term memory function after early‐life seizures. J Neurosci, 2011, 31(43): 15397-15406.
9. Lin H, Holmes GL, Kubie JL, et al. Recurrent seizures induce a reversible impairment in a spatial hidden goal task. Hippocampus, 2009, 19: 817-827.
10. Elsharkawy AE, Alabbasi AH, Pannek H, et al. Outcome of frontal lobe epilepsy surgery in adults. Epilepsy Res, 2008, 81(2-3): 97-106.
11. Francesca B, Aileen MG, Didier S, et al. Predictive factors of surgical outcome in frontal lobe epilepsy explored with stereoelectroencephalography. Neurosurgery, 2018, 83(2): 217-225.
12. Tigaran S, Cascino GD, McClelland RL, et al. Acute postoperative seizures after frontal lobe cortical resection for intractable partial epilepsy. Epilepsia, 2003, 44(41): 831-835.
13. 张弨, 胡文瀚, 王秀, 等. 额叶癫痫简单运动症状和复杂运动症状临床特点及癫痫传播网络的研究. 临床神经外科杂志, 2020, 17(2): 145-149.

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Analysis of the curative effect and predictive factors of frontal lobe epilepsy after surgery

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