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Master Thesis

Trente ans de chirurgie de l’épilepsie à Grenoble : résultats et évolution des pratiques

Abstract : Epilepsy surgery is recognized as the most effective way to treat patients presenting focal epilepsy which does not or insufficiently respond to antiepileptic drugs. It is associated with cognition and quality of life improvements. The last decades permitted, following progresses in the scientific knowledge on epilepsy, an improvement in diagnostic methods and their applications to identify patients eligible for epilepsy surgery. Our main aim was to evaluate postoperative seizure outcomes for patients who underwent surgery for partial drug resistant epilepsy and describe presurgical assessment techniques evolution at Grenoble University Hospital between 1990 and 2017. Results were thereafter analyzed in order to understand the impact of these advances in preoperative assessment on seizure outcome and on the clinical profile of surgical candidates. We conducted a retrospective monocentric study on cohort of 704 patients. 479 had a follow-up superior to 2 years and have thus been included for seizure outcome analysis. Overall seizures freedom (Engel class I) was 70.8% of patients at last follow-up among which 56.4% were continuously seizure-free without auras (Engel class IA). Our results also suggest that the recent technological developments in preoperative assessment have led to the emergence of new candidates for epilepsy surgery allowing them to access curative therapy, notably extra temporal lobe epilepsy, focal cortical dysplasia pathology subtype and MRI negative patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02305376
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Submitted on : Friday, October 4, 2019 - 10:07:11 AM
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  • HAL Id : dumas-02305376, version 1

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Guillaume Martin. Trente ans de chirurgie de l’épilepsie à Grenoble : résultats et évolution des pratiques. Human health and pathology. 2019. ⟨dumas-02305376⟩

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