Bjellvi et al reported risk factors for seizure worsening after epilepsy surgery. While most patients benefit from surgery, a minority may not. The authors are from University of Gottenburg and Sahlgrenska University Hospital in Sweden.
Patient selection: epilepsy surgery
Outcome: increased seizure frequency or new-onset tonic clonic seizures
Risk factors for increased seizure frequency on univariate analysis:
(1) younger age (highest rate if under 3 years of age)
(2) preoperative neurologic deficit
(3) intellectual disability (IQ <= 70)
(4) high preoperative seizure frequency (>= 30 per month)
(5) NOT temporal lobe resection (OR for temporal lobe resection
Risk factors for increased seizure frequency on multivariate analysis:
(1) younger age at surgery
(2) NOT temporal lobe resection
Risk factors for new-onset tonic clonic seizures on univariate analysis:
(1) preoperative neurologic deficit
(2) severe intellectual disability (IQ < 50)
(3) non-resective procedures
Risk factors for new-onset tonic clonic seizures on multivariate analysis:
(1) preoperative neurologic deficit
