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Jorge G. Burneo, MD, MSPH; Lorie Black, RN; Roy Martin, PhD; Orrin Devinsky, MD; Steve Pacia, MD; Edward Faught, MD; Blanca Vasquez, MD; Robert C. Knowlton, MD; Daniel Luciano, MD; Werner Doyle, MD; Sohuel Najjar, MD; Ruben I. Kuzniecky, MD

Arch Neurol. 2006;63:1106-1110.

Background  Several risk factors have been attributed to seizure recurrence after surgery. It is unknown whether race/ethnicity plays a role in outcome.

Objective  To evaluate whether race/ethnicity plays a role in seizure recurrence after surgery.

Design  Cohort study.

Setting  We evaluated data obtained from the epilepsy centers at the University of Alabama at Birmingham and New York University, New York, NY.

Patients  All patients included had a diagnosis of mesial temporal sclerosis and underwent temporal lobectomy.

Main Outcome Measures  Occurrence of seizure after surgery was registered 1 year after surgery. We used multiple logistic regression analysis to model the presence of seizure recurrence after surgery and generated odds ratios (ORs) for seizure recurrence after surgery for African American and Hispanic patients relative to white patients. An unadjusted model incorporated only race/ethnicity as the independent variable, and an adjusted model included socioeconomic status, age, duration of epilepsy, education, history of febrile seizures, sex, handedness, lateralization of epileptogenic focus, and number of antiepileptics as the independent variables.

Results  Two hundred fifty-two patients underwent surgical treatment with pathological confirmation of mesial temporal sclerosis. No differences were found between racial/ethnic groups in terms of seizure recurrence in any models. For African American patients, the ORs were 0.9 (95% confidence interval [CI], 0.4-2.1) for the unadjusted model and 0.8 (95% CI, 0.3-2.0) for the adjusted model; for Hispanic patients, the ORs were 1.6 (95% CI, 0.8-3.2) for the unadjusted model and 1.1 (95% CI, 0.5-2.6) for the adjusted model, relative to white patients.

Conclusion  Our data suggest that although sex appears to play a role in the outcomes of surgery for temporal lobe epilepsy, race and socioeconomic status do not.

Author Affiliations: Epilepsy Programme, University of Western Ontario, London Health Sciences Centre, London (Dr Burneo); Epilepsy Center, University of Alabama at Birmingham (Ms Black and Drs Martin, Faught, and Knowlton); and Comprehensive Epilepsy Program, New York University, New York, NY (Drs Devinsky, Pacia, Vasquez, Luciano, Doyle, Najjar, and Kuzniecky).

RELATED LETTERS

Sex as a Prognostic Factor for Surgical Outcome in Mesial Temporal Lobe Epilepsy
Marino M. Bianchin, Tonicarlo R. Velasco, Ana Paula P. Martins, and Américo C. Sakamoto
Arch Neurol. 2007;64(2):288.
EXTRACT | FULL TEXT  

Sex as a Prognostic Factor for Surgical Outcome in Mesial Temporal Lobe Epilepsy—Reply
Jorge G. Burneo and Ruben I. Kuzniecky
Arch Neurol. 2007;64(2):288-289.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Sex as a Prognostic Factor for Surgical Outcome in Mesial Temporal Lobe Epilepsy
Bianchin et al.
Arch Neurol 2007;64:288-288.
FULL TEXT