Seizure Outcome After Lesional Epilepsy Surgery: a Report of the First Comprehensive Epilepsy Surgery Program in Iran (P1.274)

Objective: to investigate the utility and postoperative outcome of surgery in patients with lesional epilepsy in a relatively resource poor setting, in Iran. Background: Surgery is a major, efficacious, treatment option for medically intractable epilepsy. Design/Methods: This prospective longitudinal study was conducted during 2007–2017 in the Kashani Comprehensive Epilepsy Center in Isfahan, Iran. Patients with a diagnosis of intractable focal epilepsy, with MRI lesions, who underwent epilepsy surgery and were followed up for more than 24 months, were included for study and were evaluated for postoperative outcome. Results: A total of 214 patients, with mean age 26.90 ± 9.82 years (59.8% male) were studied. Complex partial seizure was the most common seizure type (85.9%) and 54.2% of cases had auras. Temporal lobe lesions and mesial temporal sclerosis were the most frequent etiologies (75.2% and 48.1%, respectively). With mean follow up of 62.17 ± 19.33 months, 81.8% of patients became seizure free postoperatively. Anticonvulsants were reduced in 86% of cases and discontinued in 40.7%. We found that seizure-freedom rates were lower among patients with longer follow-up periods. Also, abnormal, epileptiform postoperative EEGs were significantly more frequent in the non-seizure free group (p Conclusions: We found high rates of seizure freedom after surgery in lesional epilepsy patients despite limited facilities and infrastructure; antiepileptic medications were successfully tapered in almost half of the patients studied. Considering the favorable outcome of epilepsy surgery in our series, we believe that it is a major treatment option, even in less resource intensive settings, and should be encouraged. Strategies to allow larger scale utility of epilepsy surgery in such settings in the developing world, and dissemination of such knowledge may be considered an urgent clinical need, given the established mortality and morbidity in refractory epilepsy. Study Supported by: Vice-chancellor for research and technology of Isfahan University of Medical Sciences Disclosure: Dr. Badihian has nothing to disclose. Dr. Mehvari Habibabadi has nothing to disclose. Dr. Moein has nothing to disclose. Dr. Basiratnia has nothing to disclose. Dr. Zaki has nothing to disclose. Dr. Manouchehri has nothing to disclose. Dr. Zare has nothing to disclose. Dr. Barekatain has nothing to disclose. Dr. Rahimian has nothing to disclose. Dr. Mehvari Habibabadi has nothing to disclose. Dr. Moein has nothing to disclose. Dr. Agha-Khani has nothing to disclose. Dr. Amina has nothing to disclose. Dr. Lhatoo has nothing to disclose.