Table 10.8 Studies Examining Surgical Treatment of Post-Traumatic Seizures
Author Year Country Research Design PEDro Sample Size |
Methods | Outcome |
Won et al. (2017) Germany Cohort N=139 |
Population: (subdural hematoma): Mean Age=72.7yr; Gender: Males=94, Females=45; GCS: ≤8=73, >8=66. Intervention: Patients either received a craniotomy or a craniectomy. Outcome Measure: Risk factors for seizure incidence, seizure frequency, functional outcome at 3 mo. |
1. A GCS score of ≤8 was seen as a significant predictor of post-traumatic seizures (p=0.03). Additionally, having a GCS score of ≤8 24hr post-op was also seen to significantly predict post-traumatic seizures (p=0.008). 2. There was no significant difference in terms of seizure frequency between those who received a craniotomy compared to a craniectomy (p=0.06). 3. There was no significant difference in functional outcomes between groups. |
Zheng et al. (2013) USA Case Series N=97 |
Population: Tumor; Mean Age=51.4yr; Gender: Male=38, Female=59. Treatment: Patients with supratentorial meningioma were retrospectively analyzed after surgical resection for postoperative seizures. Seizures were divided into postoperative early (<1wk) and late (>1wk) occurrence. Outcome Measure: Seizure rates. |
1. Sixty-two (63.9%) of the 97 patients were seizure free for the entire postoperative follow-up. 2. Thirteen (13.4%) of the 97 patients experienced frequent seizures. 3. Fourteen (14.4%) of the 97 patients experienced early postoperative seizures. 4. Thirty-three (34.0%) of the 97 patients experienced late postoperative seizures include 12 of the 14 patients who experienced early seizures. |
Hakimian et al. (2012) USA Case Series N=21 |
Population: TBI; Mean Age=34.7yr; Gender: Male=12, Female=9; Time Post Injury=12.9yr.
Treatment: Retrospective review of patients who had an extratemporal resection (with or without temporal lobectomy) for medically intractable epilepsy.
Outcome Measure: Occurrence of seizures (mean follow-up was 7yr). |
1. Most patients had both frequent complex partial and generalized tonic-clonic seizures and were unsuccessfully treated with an average of 4.15 antiepileptic drugs. 2. Six patients were seizure-free, six patients had rare seizures (≤2/yr), five had a reduction in frequency, and 4 had no benefit from the surgery. 3. Two patients had significant complications (subdural hematomas). |
(1995) USA Case Series N=25 |
Population: Head Trauma; Gender: Male=17, Female=8. Treatment: Participants underwent surgical resection when seizures could be localized. Outcome Measure: Occurrence of seizures. |
1. Prior to surgery seizures were localized to the mesial temporal region (Group 1, n=17) and extrahippocampal neocortical area (Group 2, n=8). 2. Nine patients had their seizures successfully localized and underwent a surgical procedure. Afterwards, all were seizure free. 3. 16 patients did not have their seizures adequately localized. |