دورية أكاديمية
Epilepsy surgery in children with genetic etiologies: A prospective evaluation of current practices and outcomes.
| العنوان: | Epilepsy surgery in children with genetic etiologies: A prospective evaluation of current practices and outcomes. |
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| المؤلفون: | Coryell J; Department of Pediatrics, Oregon Health & Sciences University, CDRC-P, 707 SW Gaines Rd, Portland, OR 97239, USA. Electronic address: coryellj@ohsu.edu., Singh R; Division of Neurology, Department of Pediatrics, Atrium Health/Levine Children's Hospital, Charlotte, NC, USA., Ostendorf AP; Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA., Eisner M; Biostatistics Resource at Nationwide Children's Hospital, Columbus, Ohio, USA., Alexander A; Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Pediatric Neurosurgery, Children's Hospital Colorado, Aurora, CO, USA., Eschbach K; Department of Neurology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Shrey DW; Children's Hospital of Orange County, Orange, CA, USA., Olaya J; Children's Hospital of Orange County, Orange, CA, USA., Ciliberto MA; Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA., Karakas C; Department of Neurology, Division of Child Neurology, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, USA., Karia S; Department of Neurology, Division of Child Neurology, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, KY, USA., McNamara N; Department of Pediatrics, Section of Pediatric Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA., Romanowski EF; Department of Pediatrics, Section of Pediatric Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA., Kheder A; Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA., Pradeep J; Department of Pediatric Neurology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA., Reddy SB; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA., McCormack MJ; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA., Bolton J; Department of Neurology, Boston Children's Hospital, Boston, MA, USA., Wolf S; Boston Children's Health Physicians of New York and Connecticut, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA., McGoldrick P; Boston Children's Health Physicians of New York and Connecticut, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA., Hauptman JS; Division of Pediatric Neurosurgery, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Samanta D; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Tatachar P; Department of Pediatrics, Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA., Sullivan J; University of California San Francisco Weill Institute for Neurosciences, Benioff Children's Hospital, San Francisco, CA, USA., Auguste K; University of California San Francisco Weill Institute for Neurosciences, Benioff Children's Hospital, San Francisco, CA, USA., Gonzalez-Giraldo E; University of California San Francisco Weill Institute for Neurosciences, Benioff Children's Hospital, San Francisco, CA, USA., Marashly A; Department of Neurology, Johns Hopkins, Baltimore, MD, USA., Depositario-Cabacar DF; Center for Neuroscience, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA., Wong-Kisiel LC; Department of Neurology, Divisions of Child Neurology and Epilepsy, Mayo Clinic College of Medicine, Rochester, MN, USA., Perry S; Jane and John Justin Institute for Mind Health, Cook Children's Medical Center, Fort Worth, TX, USA. |
| المصدر: | Seizure [Seizure] 2023 Dec; Vol. 113, pp. 6-12. Date of Electronic Publication: 2023 Oct 25. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 9306979 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2688 (Electronic) Linking ISSN: 10591311 NLM ISO Abbreviation: Seizure Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Elsevier Original Publication: London : Baillière Tindall, c1992- |
| مواضيع طبية MeSH: | Epilepsy*/genetics , Epilepsy*/surgery, Child ; Humans ; Seizures ; Databases, Factual ; Neuroimaging ; Probability |
| مستخلص: | Objective: This study assesses current practices and outcomes of epilepsy surgery in children with a genetic etiology. It explores the pre-surgical workup, types of surgeries, and post-surgical outcomes in a broad array of disorders. Methods: Patients ≤18 years who completed epilepsy surgery and had a known genetic etiology prior to surgical intervention were extrapolated from the Pediatric Epilepsy Research Consortium (PERC) surgery database, across 18 US centers. Data were assessed univariably by neuroimaging and EEG results, genetic group (structural gene, other gene, chromosomal), and curative intent. Outcomes were based on a modified International League Against Epilepsy (ILAE) outcome score. Results: Of 81 children with genetic epilepsy, 72 % had daily seizures when referred for surgery evaluation, which occurred a median of 2.2 years (IQR 0.3, 5.2) after developing drug resistance. Following surgery, 68 % of subjects had >50 % seizure reduction, with 33 % achieving seizure freedom [median follow-up 11 months (IQR 6, 17). Seizure freedom was most common in the monogenic structural group, but significant palliation was present across all groups. Presence of a single EEG focus was associated with a greater likelihood of seizure freedom (p=0.02). Significance: There are meaningful seizure reductions following epilepsy surgery in the majority of children with a genetic etiology, even in the absence of a single structural lesion and across a broad spectrum of genetic causes. These findings highlight the need for expedited referral for epilepsy surgery and support of a broadened view of which children may benefit from epilepsy surgery, even when the intent is palliative. Competing Interests: Declaration of Competing Interest Allyson Alexander, MD is a consultant for NuXceland. All additional authors report no declarations of interest. (Copyright © 2023 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Epilepsy; Genetic; Pediatric; Surgery |
| تواريخ الأحداث: | Date Created: 20240108 Date Completed: 20240109 Latest Revision: 20240109 |
| رمز التحديث: | 20240109 |
| DOI: | 10.1016/j.seizure.2023.10.011 |
| PMID: | 38189708 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-2688 |
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| DOI: | 10.1016/j.seizure.2023.10.011 |