• Ali A Asadi-Pooya, Maromi Nei, Ashwini Sharan, and Michael R Sperling.
• Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Electronic address: aliasadipooya@yahoo.com.
• World Neurosurg. 2016 Jul 1; 91: 205-9.

ObjectiveTo investigate the possible influence of risk factors on seizure outcome after surgery for drug-resistant nonlesional temporal lobe epilepsy (TLE).MethodsThis retrospective study recruited patients with drug-resistant nonlesional TLE who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center and were followed for a minimum of 1 year. Patients had been prospectively registered in a database from 1991 to 2014. Postsurgical outcome was classified into 2 groups: seizure free or relapsed. The possible risk factors influencing long-term seizure outcome after surgery were investigated.ResultsNinety-five patients (42 males and 53 females) were studied. Fifty-four (56.8%) patients were seizure free. Only a history of febrile seizure in childhood affected the risk of postoperative seizure recurrence (odds ratio, 0.22; 95% confidence interval, 0.06-0.83; P = 0.02). Gender, race, family history of epilepsy, history of status epilepticus, duration of disease before surgery, aura symptoms, IQ, and seizure type or frequency were not predictors of outcome.ConclusionsMany patients with drug-resistant nonlesional TLE responded favorably to surgery. The only factor predictive of seizure outcome after surgery was a history of febrile seizure in childhood. It is critical to distinguish among different types of TLE when assessing outcome after surgery.Copyright © 2016 Elsevier Inc. All rights reserved.

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