PREDIKTOR KEJADIAN KEJANG PASCAOPERASI BEDAH EPILEPSI LOBUS TEMPORAL PADA PENDERITA EPILEPSI LOBUS TEMPORAL

Abstract

Background Changes in seizure-free status after surgery in patient with temporal lobe epilepsy (TLE) are indicator for the successful of surgery. Clinical characteristic (age at surgery, age at onset, duration of epilepsy, seizure frequency per month, aura) and results of preoperative evaluation (semiology, tape of electroencephalogram (EEG), result of magnetic resonance imaging (MRI)) have been linked to seizure-free status after surgery. Aim This study aims to determine the factors that may affect seizure-free status in epilepsy patients after temporal lobe epilepsy surgery Method This is an analytical observational studies with case control study design. The samples were taken with consecutive sampling. Subjects were 20 patients which is not seizure free after had TLE surgery (case) and 41 patients which is seizure free after had TLE surgery (control). The variables, consist of clinical characteristic and results of preoperative evaluation, were collected from medical record of the subjects. The statistical tests used were Mann Whitney , unpaired t test and Chi-square test. Results Risk factors associated with seizure free-status after TLE surgery were age at onset of epilepsy ≤ 10 years (OR:3,4;95%CI:1,0 to 10,9), non TLE aura (OR:23,4;95%CI:2,5 to 219,2) and absence of epilepsy focus in MRI (OR:4,1;95%CI:1,6 to 10,9). Duration of epilepsy ≥ 10 years (OR:2,3), seizure frequency > 4 times per month (OR:2,3) and positive automatism (OR:1,5) can’t yet be concluded as a risk factor. Conclusion Age at onset of epilepsy ≤ 10 years, non TLE aura, and absence of epilepsy focus in MRI were risk factors that associated with seizure-free status after surgery. Keywords Temporal lobe epilepsy, seizure-free status after TLE surgery.