Abstract:
We present our 10-year experience and preoperative predictors of outcome in 93 adults and children who underwent epilepsy surgery at the American University of Beirut. Presurgical evaluation included video-EEG monitoring, MRI, neuropsychological assessment with invasive monitoring, and other tests (PET, SPECT, Wada). Surgeries included temporal (54percent), extratemporal (22percent), and multilobar resections (13percent), hemispherectomy (4percent), vagal nerve stimulation (6percent), and corpus callosotomy (1percent). Mesial temporal sclerosiswas the mostcommonaetiology (37percent). After resective surgery, 70percent had Engel class I, 9percent class II, 14percent class III, and 7percent class IV. The number of antiepileptic drugs before surgery was the only preoperative factor associated with Engel class I (p=0.005). Despite the presence of financial and philanthropic aid, many patients could not be operated on for financial reasons. We conclude that advanced epilepsy presurgical workups, surgical procedures, and favourable outcomes, comparable to those of developed countries, are achievable in developing countries, but that issues of financial coverage remain to be addressed.