Age of meningitis or encephalitis is independently predictive of outcome from anterior temporal lobectomy

Terence J. O'Brien, Harold Moses, Denise Cambier, Gregory D Cascino

Research output: Contribution to journalArticle

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Abstract

Background: The occurrence of meningitis or encephalitis in early childhood, i.e., ≤4 years of age, may be associated with both the development of medial temporal lobe epilepsy (MTLE) and an excellent operative outcome following an anterior temporal lobectomy (ATL). However, whether the predictive value of this risk factor for partial epilepsy is independent of the finding of mesial temporal sclerosis (MTS) on MRI is not known. Methods: Consecutive patients (n = 39) with a remote history of meningitis or encephalitis who underwent an ATL were compared with 78 sex-and age-matched control subjects who had not experienced a CNS infection before ATL. All patients in both groups had nonlesional temporal lobe epilepsy and were followed up for at least 12 months postoperatively. Results: There was a trend for the patients with a history of meningitis or encephalitis to have a lower frequency of class I postoperative outcome (61.5% vs 73.1%, p = 0.21). In the meningitis or encephalitis group, a class I outcome was more frequent in those with a history of meningitis or encephalitis at a young age (<4 years) (19/23 vs 5/16, p = 0.002), those with MTS detected on a preoperative MRI (22/31 vs 2/8, p = 0.04), and those with a history of meningitis (16/21 vs 8/18, p = 0.05). Multivariate logistic regression analysis found that a history of meningitis or encephalitis at a young age (b = 2.0, O.R. = 7.5, p = 0.048) was predictive of a class I outcome independent of the presence of MRI-identified MTS (b = 2.0, O.R. = 7.3, p = 0.07). Conclusion: The age of occurrence of a remote history of meningitis or encephalitis, but not the type of infection, is predictive of outcome after an ATL independent of the finding of MTS on the preoperative MRI.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalNeurology
Volume58
Issue number1
StatePublished - Jan 8 2002

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Anterior Temporal Lobectomy
Encephalitis
Meningitis
Sclerosis
Temporal Lobe Epilepsy
Partial Epilepsy
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Age of meningitis or encephalitis is independently predictive of outcome from anterior temporal lobectomy. / O'Brien, Terence J.; Moses, Harold; Cambier, Denise; Cascino, Gregory D.

In: Neurology, Vol. 58, No. 1, 08.01.2002, p. 104-109.

Research output: Contribution to journalArticle

O'Brien, Terence J. ; Moses, Harold ; Cambier, Denise ; Cascino, Gregory D. / Age of meningitis or encephalitis is independently predictive of outcome from anterior temporal lobectomy. In: Neurology. 2002 ; Vol. 58, No. 1. pp. 104-109.
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abstract = "Background: The occurrence of meningitis or encephalitis in early childhood, i.e., ≤4 years of age, may be associated with both the development of medial temporal lobe epilepsy (MTLE) and an excellent operative outcome following an anterior temporal lobectomy (ATL). However, whether the predictive value of this risk factor for partial epilepsy is independent of the finding of mesial temporal sclerosis (MTS) on MRI is not known. Methods: Consecutive patients (n = 39) with a remote history of meningitis or encephalitis who underwent an ATL were compared with 78 sex-and age-matched control subjects who had not experienced a CNS infection before ATL. All patients in both groups had nonlesional temporal lobe epilepsy and were followed up for at least 12 months postoperatively. Results: There was a trend for the patients with a history of meningitis or encephalitis to have a lower frequency of class I postoperative outcome (61.5{\%} vs 73.1{\%}, p = 0.21). In the meningitis or encephalitis group, a class I outcome was more frequent in those with a history of meningitis or encephalitis at a young age (<4 years) (19/23 vs 5/16, p = 0.002), those with MTS detected on a preoperative MRI (22/31 vs 2/8, p = 0.04), and those with a history of meningitis (16/21 vs 8/18, p = 0.05). Multivariate logistic regression analysis found that a history of meningitis or encephalitis at a young age (b = 2.0, O.R. = 7.5, p = 0.048) was predictive of a class I outcome independent of the presence of MRI-identified MTS (b = 2.0, O.R. = 7.3, p = 0.07). Conclusion: The age of occurrence of a remote history of meningitis or encephalitis, but not the type of infection, is predictive of outcome after an ATL independent of the finding of MTS on the preoperative MRI.",
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