Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

Abstract

Objective: To investigate the surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS) and neurocysticercosis (NCC). Methods: A retrospective investigation of patients with TLE-HS was conducted in a tertiary center. Results: Seventy-nine (62.2%), 37 (29.1%), 6 (4.7%), and 5 (3.9%) patients were Engel class I, II, III, and IV, respectively. Fifty-two (71.2%) patients with epilepsy durations ≤ 10 years prior to surgery were seizure-free 1 year after the operation compared to 27 (50.0%) patients with epilepsy durations > 10 years (p = 0.0121). Forty-three (72.9%) patients with three or fewer lobes affected by NCC were seizure-free one year after the operation, and 36 (52.9%) patients with more than three involved lobes were seizure-free after surgery (p = 0.0163). Conclusions: Longer epilepsy durations and multiple lobe involvement predicted worse seizure outcomes in TLE-HS plus NCC patients._________________________________________________________________________________________ RESUMO: Objetivo: Investigar o resultado cirúrgico da epilepsia do lobo temporal associada à esclerose hipocampal (TLE-HS) e neurocisticercose (NCC). Métodos: Estudo retrospectivo realizado em um centro de epilepsia. Resultados: Cinqüenta e dois pacientes (71,2%) com 10 anos ou menos de epilepsia antes da cirurgia tornaram-se livres de crises após um ano da operação, enquanto que 27 (50,0%) com mais de dez anos tornaram-se livres de crises após a cirurgia (p = 0,0121). Quarenta e três pacientes (72,9%), com três ou menos lobos afetados pela NCC tornaram-se livres de crises após um ano de operação, enquanto que 36 pacientes (52,9%) com mais de três lobos envolvidos estavam livres de crises após a cirurgia (p = 0,0163). Conclusão: A duração mais longa da epilepsia e o envolvimento de múltiplos lobos prevê pior resultado após a cirurgia para TLE-HS mais NCC.