已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

Insular epilepsy surgery: lessons learned from institutional review and patient-level meta-analysis.

医学 荟萃分析 癫痫外科 癫痫 梅德林 清醒开颅术 优势比 回顾性队列研究
作者
Panagiotis Kerezoudis,Rohin Singh,Anshit Goyal,Gregory A. Worrell,W. Richard Marsh,Jamie J. Van Gompel,Kai J. Miller
出处
期刊:Journal of Neurosurgery [Journal of Neurosurgery Publishing Group]
卷期号:-1: 1-13
标识
DOI:10.3171/2021.1.jns203104
摘要

OBJECTIVE Insular lobe epilepsy is a challenging condition to diagnose and treat. Due to anatomical intricacy and proximity to eloquent brain regions, resection of epileptic foci in that region can be associated with significant postoperative morbidity. The aim of this study was to review available evidence on postoperative outcomes following insular epilepsy surgery. METHODS A comprehensive literature search (PubMed/MEDLINE, Scopus, Cochrane) was conducted for studies investigating the postoperative outcomes for seizures originating in the insula. Seizure freedom at last follow-up (at least 12 months) comprised the primary endpoint. The authors also present their institutional experience with 8 patients (4 pediatric, 4 adult). RESULTS A total of 19 studies with 204 cases (90 pediatric, 114 adult) were identified. The median age at surgery was 23 years, and 48% were males. The median epilepsy duration was 8 years, and 17% of patients had undergone prior epilepsy surgery. Epilepsy was lesional in 67%. The most common approach was transsylvian (60%). The most commonly resected area was the anterior insular region (n = 42, 21%), whereas radical insulectomy was performed in 13% of cases (n = 27). The most common pathology was cortical dysplasia (n = 68, 51%), followed by low-grade neoplasm (n = 16, 12%). In the literature, seizure freedom was noted in 60% of pediatric and 69% of adult patients at a median follow-up of 29 months (75% and 50%, respectively, in the current series). A neurological deficit occurred in 43% of cases (10% permanent), with extremity paresis comprising the most common deficit (n = 35, 21%), followed by facial paresis (n = 32, 19%). Language deficits were more common in left-sided approaches (24% vs 2%, p < 0.001). Univariate analysis for seizure freedom revealed a significantly higher proportion of patients with lesional epilepsy among those with at least 12 months of follow-up (77% vs 59%, p = 0.032). CONCLUSIONS These findings may serve as a benchmark when tailoring decision-making for insular epilepsy, and may assist surgeons in their preoperative discussions with patients. Although seizure freedom rates are quite high with insular epilepsy treatment, the associated morbidity needs to be weighed against the potential for seizure freedom.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
刚刚
1秒前
2秒前
4秒前
咿咿呀呀发布了新的文献求助10
5秒前
可可发布了新的文献求助10
6秒前
7秒前
9秒前
狗不李发布了新的文献求助10
9秒前
10秒前
11秒前
薄荷小姐完成签到 ,获得积分10
11秒前
邱邱发布了新的文献求助10
13秒前
junjun发布了新的文献求助10
13秒前
blue2021发布了新的文献求助10
14秒前
16秒前
子桑南发布了新的文献求助300
16秒前
16秒前
王王发布了新的文献求助10
16秒前
笨笨的秋发布了新的文献求助10
17秒前
满意的柏柳应助yelie采纳,获得10
19秒前
20秒前
ured发布了新的文献求助10
20秒前
狗不李完成签到,获得积分20
20秒前
22秒前
25秒前
笑笑发布了新的文献求助10
25秒前
zzz完成签到,获得积分10
25秒前
27秒前
jihenyouai0213完成签到,获得积分10
27秒前
29秒前
拉长的沛芹完成签到,获得积分10
30秒前
现代的自行车完成签到 ,获得积分10
30秒前
32秒前
笑笑完成签到,获得积分10
32秒前
梦璃安发布了新的文献求助10
33秒前
打打应助ured采纳,获得10
33秒前
34秒前
34秒前
高分求助中
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
юрские динозавры восточного забайкалья 800
English Wealden Fossils 700
Chen Hansheng: China’s Last Romantic Revolutionary 500
宽禁带半导体紫外光电探测器 388
COSMETIC DERMATOLOGY & SKINCARE PRACTICE 388
Case Research: The Case Writing Process 300
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3142265
求助须知:如何正确求助?哪些是违规求助? 2793200
关于积分的说明 7805849
捐赠科研通 2449486
什么是DOI,文献DOI怎么找? 1303333
科研通“疑难数据库(出版商)”最低求助积分说明 626823
版权声明 601291