Complications of epilepsy surgery in Sweden 1996–2010: a prospective, population-based study

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OBJECT

Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series.

METHODS

The Swedish National Epilepsy Surgery Register provides extensive population-based data on all patients who were surgically treated in Sweden since 1990. The authors have analyzed complication data for therapeutic epilepsy surgery procedures performed between 1996 and 2010. Complications are classified as major (affecting daily life and lasting longer than 3 months) or minor (resolving within 3 months).

RESULTS

A total of 865 therapeutic epilepsy surgery procedures were performed between 1996 and 2010, of which 158 were reoperations. There were no postoperative deaths. Major complications occurred in 26 procedures (3%), and minor complications in 65 (7.5%). In temporal lobe resections (n = 523), there were 15 major (2.9%) and 41 minor complications (7.8%); in extratemporal resections (n = 275) there were 9 major (3.3%) and 22 minor complications (8%); and in nonresective procedures (n = 67) there were 2 major (3%) and 2 minor complications (3%). The risk for any complication increased significantly with age (OR 1.26 per 10-year interval, 95% CI 1.09–1.45). Compared with previously published results from the same register, there is a trend toward lower complication rates, especially in patients older than 50 years.

CONCLUSIONS

This is the largest reported prospective series of complication data in epilepsy surgery. The complication rates comply well with published results from larger single centers, confirming that epilepsy surgery performed in the 6 Swedish centers is safe. Patient age should be taken into account when counseling patients before surgery.

ABBREVIATIONSAH = amygdalohippocampectomy; SNESUR = Swedish National Epilepsy Surgery Register; TLR = temporal lobe resection.

Article Information

Correspondence Kristina Malmgren, Epilepsy Research Group, Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, Per Dubbsgatan 14 1 tr, Sahlgrenska Academy at University of Gothenburg, 413 45 Göteborg, Sweden. email: kristina.malmgren@neuro.gu.se.

INCLUDE WHEN CITING Published online October 31, 2014; DOI: 10.3171/2014.9.JNS132679.

DISCLOSURE This study was funded by grants from the Swedish Research Council (Grant No. 521-2011-169) and the Sahlgrenska Academy at Gothenburg University through the LUA/ALF agreement (Grant No. ALFGBG137431).

© AANS, except where prohibited by US copyright law.

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    Bar graph showing number of patients and complication frequencies in relation to age (in years) at surgery.

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