• World Neurosurg · Apr 2024

    Surgical outcome of pharmaco refractory epilepsy in the National Epilepsy Center of Sri Lanka.

    • K M I U Ranasinghe, Sunethra Senanayake, Sudath Gunasekara, Sanjeewa Garusinghe, Deepal Attanayake, Jithangi Wanigasinghe, Sanjaya Fernando, Bimal Kudavidanage, Anil de Silva, Chathurie Suraweera, Sachintha Satharasinghe, Salika Karunanayaka, Sameera Jayan Senanayake, and Inuka Kishara Gooneratne.
    • Institution of Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka. Electronic address: indrachaparanasinghe@gmail.com.
    • World Neurosurg. 2024 Apr 1; 184: e494e502e494-e502.

    BackgroundThe National Epilepsy Center (NEC) in Sri Lanka was established in 2017. Seizure outcome, effects on quality of life (QOL) and surgical complications among nonpediatric patients who underwent epilepsy surgery from October 2017 to February 2023 are described.MethodsNineteen patients (≥14 years) underwent epilepsy surgery at the NEC. We used Engel classification and Quality of Life in Epilepsy 31 (QOLIE-31) questionnaire to assess seizure outcome and QOL respectively. Surgical complications were categorized into neurological and complications related to surgery.ResultsNine female and 10 male patients underwent surgery (mean age 27.5 years (range 14-44 years). The mean follow-up duration was 10.5 months (range 6-55 months). Twelve patients underwent temporal lobe resections. At 6-months follow-up, 83.3% (10/12) had favorable seizure outcomes with Engel class I/II. At 1-year follow-up 6/8 patients (75.0%) and at 2-year follow-up, 5/7 patients (71.4%) had a favorable outcome. Seven patients had extra-temporal lobe surgeries and one defaulted. Seizure freedom was observed in 6/6 at 6 months, 3/3 at 1-year, and 2/2 at 2-year follow-up. Five patients (26.3%) experienced minor post-operative surgical site infection. Two (11.1%) had persistent quadrantanopia. Meaningful improvement in QOL (change in QOLIE-31 score ≥11.8) was observed irrespective of seizure outcome or type of surgery (P < 0.001).ConclusionsEpilepsy surgery is effective in developing countries. Seizure outcomes in our patients are comparable to those worldwide. Clinically important QOL improvement was observed in our series. This is the first published data on epilepsy surgery outcomes in nonpediatric patients from Sri Lanka.Copyright © 2024 Elsevier Inc. All rights reserved.

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