Postsurgical outcome in patients with auditory auras and drug-resistant epilepsy |
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| Institution: | 1. Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children''s Hospital, Boston, MA, USA;2. F.M. Kirby Neurobiology Center, Boston Children''s Hospital, Boston, MA, USA;3. Neuromodulation Program, Division of Pediatric Neurology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA;4. Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA;1. Division of Neurochemistry and Neuropathology, Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland;2. Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland;3. Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, 34, Dojazd st., 60-631 Poznan, Poland;4. Division of Neuroimmunology, Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland;5. Department of Neurology, Poznan University of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland |
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| Abstract: | PurposeWe assessed whether patients with auditory auras have similar outcomes after epilepsy surgery as patients without auditory auras, and hypothesized that patients with non-dominant hemisphere foci might fare better after temporal lobe surgery than patients with dominant resections.MethodsIn this retrospective study, outcome after temporal resection was assessed for patients with drug-resistant epilepsy. Preoperative demographic data, clinical data, and surgical outcome were prospectively registered in a database from 1986 through 2016. Seizure outcome was classified as either seizure-free or relapsed.ResultsData were available in 1186 patients. Forty five patients (3.8%) reported auditory auras; 42 patients (93%) had temporal lobe epilepsy (TLE), and three patients (7%) had extratemporal epilepsy. Since most patients with auditory auras had TLE and in order to have comparable groups, we selected 41 patients with auditory auras and compared them with patients without auditory auras who had temporal lobe resections (767 patients). There were no significant demographic or clinical differences between TLE patients with auditory auras and those without. Patients who had auditory auras were more likely to relapse after temporal lobe surgery than those without (p = 0.03). Among patients who had auditory auras and temporal lobe surgery, side of surgery was not related to postoperative outcome (p = 0.3).ConclusionAuditory auras are rare among patients with drug-resistant TLE. The presence of an auditory aura in a patient with drug-resistant TLE carries a worse prognosis for a postoperative seizure free outcome and this is not related to the side of surgery. |
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