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PubMed · 1835997

Temporal lobectomy: a promising alternative.

K L Rusy
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Abstract

Recent advances in the neurosciences have made temporal lobectomy a promising alternative for refractory seizures. Reportedly, postoperative seizure frequency decreases 95%. Specific criteria are used to determine a patient's suitability for surgery. Localization of the epileptogenic focus progresses from a series of noninvasive to gradually more invasive procedures. Pre- and postoperative management requires skilled nursing care. The nurse plays a vital role in patient and family education, observation and documentation of clinical events, physical care and psychological support.

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EpilepsyHumansIntraoperative CarePostoperative CarePostoperative ComplicationsPreoperative CareTemporal LobeTreatment OutcomeJournal ArticleReview

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BibTeXRIS

K L Rusy. 1991. Temporal lobectomy: a promising alternative.. https://doi.org/10.1097/01376517-199110000-00009

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BACKGROUND: Everolimus, a mechanistic target of rapamycin (mTOR) inhibitor, is increasingly used in tuberous sclerosis complex (TSC)-associated epilepsy; however, long-term real-world outcomes and factors associated with favorable response remain unclear. This study aimed to evaluate the long-term seizure outcomes of adjunctive everolimus and explore clinical factors associated with treatment response. METHODS: We retrospectively recruited 21 patients with active TSC-associated epilepsy receiving adjunctive everolimus and assessed seizure outcomes during follow-up. Clinical characteristics were compared between responders and non-responders at 1 year after treatment initiation. RESULTS: Over a median treatment duration of 72 months, responder rates ranged from 53.8% to 64.7%, and seizure-free rates ranged from 33.3% to 41.2%. Responders had fewer involved organ systems at baseline (median 3 vs. 4, p = 0.020) and lower anti-seizure medication burden (median 2 vs. 4, p = 0.045). Younger age at treatment initiation showed a trend toward improved response. CONCLUSION: Adjunctive everolimus was associated with sustained long-term seizure reduction in this real-world cohort. In exploratory analyses, fewer involved organ systems and fewer baseline ASMs were associated with favorable treatment response. These findings require validation in larger prospective cohorts.

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