Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy

Journal of Neurology, Neurosurgery, and Psychiatry
Puneet JainElysa Widjaja

Abstract

To evaluate the effectiveness of anterior temporal lobectomy (ATL) versus selective amygdalohippocampectomy (SAH) on seizure-free outcome in patients with temporal lobe epilepsy, using both direct and indirect evidence from the literature. MEDLINE, Embase and Cochrane databases were searched for original research articles and systematic reviews comparing ATL versus SAH, and ATL or SAH versus medical management (MM). The outcome was seizure freedom at 12 months of follow-up or longer. Direct pairwise meta-analyses were conducted, followed by a random-effect Bayesian network meta-analysis (NMA) combining direct and indirect evidence. Twenty-eight articles were included (18 compared ATL vs SAH, 1 compared ATL vs SAH vs MM, 8 compared ATL vs MM, and 1 compared SAH vs MM). Direct pairwise meta-analyses showed no significant differences in seizure-free outcome of ATL versus SAH (OR 1.14, 95% CI 0.93 to 1.39; p=0.201), but the odds of seizure-free outcome were higher for ATL versus MM (OR 29.16, 95% CI 10.44 to 81.50; p<0.00001), and SAH versus MM (OR 28.42, 95% CI 10.17 to 79.39; p<0.00001). NMA also showed that the odds of seizure-free outcome were no different in ATL versus SAH (OR 1.15, 95% credible interval (CrI) 0.84-1.15), but ...Continue Reading

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Citations

Feb 24, 2019·Journal of Neurosurgery·Pieter NachtergaeleTom Theys
Oct 5, 2019·Expert Review of Neurotherapeutics·Jasmina R MilovanovićSrđan Stefanović
Jul 17, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Ajmal ZemmarJoseph S Neimat
May 3, 2019·Current Neurology and Neuroscience Reports·Andreu Massot-TarrúsSeyed M Mirsattari
Nov 24, 2020·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hiroshi UdaTakeo Goto
May 8, 2021·Clinical Neurology and Neurosurgery·Alexandros G BrotisKonstantinos N Fountas
Aug 7, 2021·Frontiers in Veterinary Science·Daisuke HasegawaKazuyuki Uchida

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