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P36 A 1 and 5 year outcome analysis of epilepsy surgery in adults and children
  1. A Chadwick1,
  2. V Josan1,
  3. C Pringle2,
  4. O Pope1
  1. 1Salford Royal Foundation Trust, Salford, UK
  2. 2Royal Manchester Children’s Hospital, Manchester, UK


Objectives To evaluate the efficacy of epilepsy surgery at 1 year following surgery and to assess sustainability of seizure control at 5 years post-surgery. To find prognostic factors for good surgical outcomes.

Design Retrospective case notes analysis.

Subjects 82 consecutive patients operated on for epilepsy by a single surgeon between 2008–2013.

Methods Patients were identified in pre-existing hospital databases and included if 5 year follow-up was available. Their clinical records were accessed via the electronic patient records system at each site. The Engel Classification was used to grade seizure outcome at years 1 and 5 post-surgery. We classified Engel Class I and II as a good outcome and Engel class III and IV as a poor outcome. Case notes were also examined to find prognostic factors for a good long-term surgical outcome.

Results 86.4% of patients had a good outcome 1 year post-surgery and 77.9% had a good outcome at 5 years. The surgery site (temporal or otherwise) and the presence of a good outcome at year one were found to contribute significantly to odds of a good outcome at year 5. The ability to wean off medication is also commonly an important factor for patients and 24.4% of patients were AED free at 5 years.

Conclusions Surgery is an effective management option for intractable epilepsy in suitably selected patients with complete or near complete seizure cessation in about 80% of the patients and about a quarter of the patients no longer requiring AEDs.

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