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2 results on '"Mora-López O"'

1. Factores de riesgo para recurrencia de convulsiones y pronóstico a corto plazo en cirugía de epilepsia para esclerosis mesial temporal

Author

Restrepo-Marín Dm, Massaro-Ceballos M, Jiménez-Ramírez I, Mora-López O, Cortés-Silva E, Jaramillo-Betancur H, and Jiménez Me

Subjects
Neurology (clinical), General Medicine
Abstract

Objetivo. Determinar los factores de riesgo para recurrencia de convulsiones y la clasificacion posquirurgica a corto plazo en pacientes operados por esclerosis mesial temporal (EMT). Sujetos y metodos. Estudio de casos y controles anidado en la cohorte de pacientes con EMT diagnosticados por resonancia magnetica con dos anos de seguimiento posquirurgico; se excluyeron pacientes con EMT bilateral. Se evaluaron caracteristicas clinicas prequirurgicas, foco epileptogenico en videoelectroencefalograma (video-EEG) y variables quirurgicas con respecto a recurrencia de convulsiones en los primeros dos anos tras la intervencion y clasificacion de Engel en el primer y segundo aniversario de la cirugia. Resultados. Entre octubre de 2001 y junio de 2008 se evaluo a 144 pacientes con EMT candidatos a cirugia de epilepsia; hasta junio de 2007, se habia operado a 89 pacientes, un 51,7% con EMT izquierda. El 35,8% de los pacientes presento recurrencia de convulsiones antes del segundo ano tras la intervencion; el factor de riesgo prequirurgico asociado a recurrencia fue foco bitemporal o temporal unico con diseminacion contralateral por video-EEG (odds ratio = 6,32; intervalo de confianza al 95% = 1,64-26,41); y el posquirurgico, la presencia de convulsiones durante el primer mes tras la operacion (p = 0,0004); no se encontro asociacion con recurrencia para genero, convulsiones tonicoclonicas generalizadas prequirurgicas, lado de la EMT ni tiempo de evolucion prequirurgica de la epilepsia. El 66,3 y el 75,8% de los pacientes estaban en Engel I al primer y segundo ano de la cirugia, respectivamente. El 91% de los pacientes intervenidos estaba en buen pronostico posquirurgico a los dos anos. Conclusion. La localizacion del foco epileptogenico por electrofisiologia es un factor determinante en el pronostico posquirurgico a corto plazo en la EMT.

Published
2009

2. [Risk factors for seizure recurrence and short term outcome after epilepsy surgery for mesial temporal sclerosis].

Author

Jaramillo-Betancur H, Jiménez ME, Massaro-Ceballos M, Cortés-Silva E, Restrepo-Marín DM, Mora-López O, and Jiménez-Ramírez I

Subjects
Adolescent, Adult, Humans, Male, Retrospective Studies, Risk Factors, Treatment Outcome, Young Adult, Epilepsy physiopathology, Epilepsy surgery, Epilepsy, Temporal Lobe pathology, Epilepsy, Temporal Lobe surgery, Sclerosis pathology, Sclerosis physiopathology, Sclerosis surgery, Seizures physiopathology, Seizures surgery
Abstract

Aim: To establish risk factors for seizure recurrence and short term Engel classification after surgery for mesial temporal sclerosis (MTS)., Patients and Methods: Nested case-control study in a cohort of patients diagnosed with MTS by magnetic resonance imaging and who had at least two years of postsurgical follow-up; patients with bilateral MTS were excluded. Clinical characteristics, epileptogenic focus in video-electroencefalography (video-EEG) and surgical issues were evaluated regarding to seizure recurrence during the first two postsurgical years and Engel classification in the first and second anniversary after surgery., Results: From October 2001 to June 2008, 144 patients with MTS were evaluated as candidates for epilepsy surgery; until June 2007, 89 patients underwent epilepsy surgery, 51.7% with left MTS. 35.8% of patients experienced seizure recurrence before two post-surgical years; presurgical risk factor associated to this recurrence was bitemporal focus or single temporal focus with contralateral dissemination by video-EEG (odds ratio = 6.32; 95% confidence interval = 1.64-26.41); and post-surgical, seizures that occurred in the first month of surgery (p = 0004). No association with seizure recurrence was found with gender, presurgical tonic-clonic seizures, MTS side and epilepsy duration. 66.3% and 75.8% of patients were Engel I classified in the first and second anniversary after surgery, respectively. 91% of operated patients showed a good outcome after two years of epilepsy surgery., Conclusion: Epileptogenic focus location by electrophysiology is a fundamental factor in short term outcome after surgery for MTS.

Published
2009

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