Journal of Neurology, Neurosurgery and Psychiatry, volume 85, issue 7, pages 716-720

Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study

Publication typeJournal Article
Publication date2013-11-29
BMJ
BMJ
Q1
Q1
SJR2.959
CiteScore15.7
Impact factor8.7
ISSN00223050, 1468330X
Psychiatry and Mental health
Surgery
Neurology (clinical)
Abstract

Objective

In some patients who undergo presurgical workup for drug-resistant epilepsy invasive seizure monitoring is needed to define the seizure onset zone and delineate eloquent cortex. Such procedures carry risks for complications causing permanent morbidity and even mortality. In this study, prospective data on complications in a national population-based sample were analysed.

Design

Complication data from the prospective Swedish National Epilepsy Surgery Register were analysed for 271 patients in whom therapeutic surgery was preceded by invasive monitoring 1996–2010.

Results

Complications occurred in 13/271 patients (4.8%). Subdural grids carried the highest risk of complications (7.4%). There was no surgical mortality or permanent morbidity. Subdural haematomas were most common (n=7) followed by epidural haematomas (n=3). Valproate treatment and having a haematoma was associated with an OR of 1.53 (CI 0.38 to 6.12) compared to having a haematoma without valproate treatment. Having a complication during invasive monitoring was associated with a significant OR of 6.27 (CI 1.32 to 29.9) of also having a complication at therapeutic surgery compared to the risk of having a complication only at surgery.

Conclusions

In this prospective population-based epilepsy surgery series, the most common complications were haematomas, and subdural grids carried the highest risk. Close supervision and rapid interventions led to avoidance of permanent morbidity. The clinical implications of the slightly increased risk of haematomas with valproate treatment needs further investigation as does the finding of an increased risk for complications at epilepsy surgery for patients who had a complication during invasive monitoring.

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GOST Copy
Hedegard E. et al. Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study // Journal of Neurology, Neurosurgery and Psychiatry. 2013. Vol. 85. No. 7. pp. 716-720.
GOST all authors (up to 50) Copy
Hedegard E., Bjellvi J., Edelvik A., Rydenhag B., Flink R., Malmgren K. Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study // Journal of Neurology, Neurosurgery and Psychiatry. 2013. Vol. 85. No. 7. pp. 716-720.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1136/jnnp-2013-306465
UR - https://doi.org/10.1136/jnnp-2013-306465
TI - Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study
T2 - Journal of Neurology, Neurosurgery and Psychiatry
AU - Hedegard, E
AU - Bjellvi, J
AU - Edelvik, A
AU - Rydenhag, B.
AU - Flink, R.
AU - Malmgren, K
PY - 2013
DA - 2013/11/29
PB - BMJ
SP - 716-720
IS - 7
VL - 85
SN - 0022-3050
SN - 1468-330X
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2013_Hedegard,
author = {E Hedegard and J Bjellvi and A Edelvik and B. Rydenhag and R. Flink and K Malmgren},
title = {Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study},
journal = {Journal of Neurology, Neurosurgery and Psychiatry},
year = {2013},
volume = {85},
publisher = {BMJ},
month = {nov},
url = {https://doi.org/10.1136/jnnp-2013-306465},
number = {7},
pages = {716--720},
doi = {10.1136/jnnp-2013-306465}
}
MLA
Cite this
MLA Copy
Hedegard, E., et al. “Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study.” Journal of Neurology, Neurosurgery and Psychiatry, vol. 85, no. 7, Nov. 2013, pp. 716-720. https://doi.org/10.1136/jnnp-2013-306465.
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