Significance of post-operative auras after temporal lobectomy: A surprising methodological trap

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• 作者：Daniel W. Kinsella^a ; ^b ; Clare A. Averill^c ; Samuel F. Berkovic^a ; ^c ; ^d ; Anne M. McIntosh^a ; ^b ; ^c ; ^d ; ^e ; ^{a.mcintosh@unimelb.edu.au}
• 关键词：Post-operative simple partial seizures ; Recurrence risk ; Risk factor ; Methodology ; Seizure recurrence ; Temporal lobectomy
• 刊名：Epilepsy & Behavior
• 出版年：2012
• 期刊代码：76_15255050
• 类别：neu
• 出版时间：March, 2012
• 卷：23
• 期：3
• 页码：348-352
• 文件大小：541 K

摘要

We aimed to examine post-operative auras/simple partial seizures and the associated risk of seizure recurrence after temporal lobectomy. Included were 159 patients who underwent anterior temporal lobectomy (1995-2006) at Austin Health, Australia. Initial analyses used Cox regression. Post-hoc, exploratory analyses of aura and seizure patterns were undertaken. Initial analyses indicated that post-operative auras were not associated with subsequent disabling seizures (HR 0.65, 95%CI 0.4-1.1 p = 0.08). However, post-hoc examination found data patterns that suggest that post-operative auras may have been under-reported when medical contact between these events was absent. These findings are relevant to current research, as similar methodology is commonly employed in post-operative outcome studies. Important implications include potential underestimation of seizure risk associated with auras. Carefully planned prospective studies are required to assess the risk associated with post-operative auras.