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Journal : Medica Hospitalia

Epilepsy surgery in Indonesia: Achieving better result with limited resources Muttaqin, Zainal
Medica Hospitalia : Journal of Clinical Medicine Vol. 1 No. 1 (2012): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (450.103 KB) | DOI: 10.36408/mhjcm.v1i1.383

Abstract

Background: Even with modern medication, 30 to 40% of epilepsy patients will be intractable and this condition leads to cognitive and psychosocial decline, resulting in worse quality of life and higher mortality. With 0.5–0.6% prevalence, there will be about 1.5 million epileptic in Indonesia, about 440.000 will be intractable, and 220.000 of them are potential candidates for epilepsy surgery (ES). A decade has passed since the first ES performed on July 1999, and the number increases every year reaching 35–47 ES per year in 2007–2009. Despite the excellent result shown, all of these ES were still performed in Semarang (Diponegoro University) while the patients were from all part of Indonesia. The major reason behind the unavailability of ES in most part of the country should be discussed for the sake of future development of ES in Indonesia. Material: Epilepsy surgery was started in July 1999 with anterior temporal lobectomy for a 34 Y-old female with left mesial temporal sclerosis (MTS) causing a long standing intractable seizures. The number of cases increases every year. Until the end of 2009, there were 238 cases of epilepsy surgery, including 212 anterior temporal lobectomies. Among these, 106 cases had been follow up more than 36 months, and evaluated for surgical results. Methods: To evaluate the patient's selection and the presurgical evaluation, we divide the ES cases into the first 5 years (56 cases) and the recent 5 years (182 cases). But for the purpose of evaluating surgical results, only those with at least 36 months postoperative follow-up were included (106 cases) and grouped into those operated before or after the age of 25 Y-old (group A and group B), and into those operated before or after the length of epilepsy of 10 years (group I and group II). Results: For the first five years-period, decision to operate were based on MRI and routine interictal EEG in 54 out of 56 TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, since MRI in both patients showed visually normal MRI. For the last five years, decision to operate were based on MRI and routine EEG in 91 out of 156 TLE cases. Long term ictal EEG were performed in 46 patients, subdural grid EEG in 10 patients, PET study in 7 patients, and EcoG in 2 patients. The overall seizure free (SF) rate were 70.75%, but if grouped according to patient's age at surgery (less than or over 25 Y-old), the SF rates were 75.4% vs 66.04% respectively. So did if grouped according to length of disease (less than or more than 10 years), the SF rates were 78.72% vs 64.40% respectively. Conclusion: MRI plays very important role to decide the side of the epileptic temporal side, but this role is decreasing as it was 96.4% during the beginning five years to become 58.34% for the last five years. This means that we are working on more difficult epilepsy cases recently. SF rate was significantly higher for those who was operated at younger age and for those with shorter duration of epilepsy. This means that surgery should be offered earlier for those intractable TLE patients with obvious focus on MRI.
The Relationship Between Pre-Operative Clinical Characteristics With Changes In Post-Operative Memory Scores On Temporal Lobe Epilepsy Patient Bintoro, Aris Catur; Arifin, Muhammad Thohar; Harsono, Harsono; Muttaqin, Zainal; Hadisaputro, Soeharyo; Husni, Amin; Bakhtiar, Yuriz; Karlowe, Vega; Pratomo, Joko
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.844

Abstract

Background: Most temporal lobe epilepsy (TLE) will become seizure-free after anterior temporal lobectomy (ATL) surgery but often result in cognitive decline, specifically in verbal or visual memory. Objective: This study examined the relationship between several demographic characteristics and pre-operative clinical conditions with changes in pre-post surgical memory of TLE patients. Methods: This study used a retrospective cohort in which the subjects were TLE patients who had undergone ATL surgery at Kariadi Hospital or Telogorejo Hospital, Semarang. Demographic variables include the age of onset, duration of illness, level of education, and clinical variables include seizure frequency, EEG waveform, number of AED, lesion site, and IQ score. Results: Memory re-examination was conducted on TLE patients who had undergone surgery between 2018 and 2021, with 55 subjects who fulfilled the criteria. Characteristics of the subjects were male 31(56%) males, 38% Senior High School education, the mean age of onset was 13,87±6,899, age at surgery was 27,67±9,802, 21 (39%) normal pres-surgical EEG waveform, 31 (56%) lesion on the left and the most frequent seizures occurred in 36 subjects (65%). Statistical test results showed a significant relationship between age of onset and changes in verbal memory recognition scores (p 0.044), lesion side with changes in verbal memory task scores (p 0.018), recall (p 0.005), recognition (0.008), and IQ scores with changes in visual memory construction recall (p 0.041) Conclusion: Age of onset, lesion side, and IQ score characteristics were related to the changes in memory scores between pre- and post-operative anterior temporal lobectomy in TLE patients.
Co-Authors A'yun, Afifah Qurrota ABDUL MUJIB Ablamskyi, Serhii Achmad Fahmi, Bagus Maulana Agus Gunawan Agustina, Laili Dwi Ahmad Dardiri Ahmad Qurtubi Ahmad Rifaudin Aisyah Lahdji Ajid Risdianto Ali Firdaus Alimuddin, Khasan Amelia Cahyadini Amin Husni Aminullah Assagaf Andar, Erie Anis Fauzi, Anis Apriliani, Wella Ayu Ardi Wiranata Ardiantoro, Luki Ardiwijaya, Candra Ari, Dita NA Arifah, Cinthiya Zakiah Arifin, M. Zaenal Aris Catur Bintoro Ariyani, Hana Ariyanti, Shikita Dina Arkya, Kaela Asep Setiawan Aslamiah, Nur Asnita, Dessy Azharuddin Aziz, Moh. Mahaizaz Syifa Alwi Azizah, Alfina Dewi Nur Azizy, Rahmatika Nur Azrica, Hanita Bakhtiar, Yuriz Bakthiar, Yuriz Basuki Wasis Bayu Pramono Brahmantia, Bayu Brotoarianto, Happy Kurnia Budiana, Ijang Chatib Saefullah Cindy Elfira Boom Corryanti Corryanti Delira Riska Adriani Desi Kisbianty Desi Kisbianty, Desi Dewi Kania Sugiharti Dimas Sindhu Wibisono Dinar Mahdalena Leksana 1 Dodik Tugasworo Dwi Agus Sasongko Dwi Agus Sasongko, Dwi Agus Dwina Puspita Sari, Juli Dwinna Aliza Edi Saputra Efa Laela Fakhriah Eka Putra, Fariz Eka Setiawan, Fariz Eman Suparman Eneng Muslihah Enung Nugraha Esti Ismawati Fadlilatul Munawaroh Fatima El Zahra, Fatima Fatima El Zahraa Fatima El Zahraa Fatima El-Zahraa Fauzi, Rizki Firdaus, Zahraini Jannatul Fitria Ikhrimadhani Fitria Ramadani H Nour, Salwaa Hafil, Achmad Shodiqil Hani Handayani, Hani Harsono Harsono Hasanah, Sri Rahayu Nur Hayani, Afla Hazwar Umar HD. Hidayat Herdiani, Ida Herianto, Ii Puji Hiariej, Edward Omar Sharif Hj. Etty Mulyati Holyness Nurdin Singadimedja Husna, Nabila Miftahul I. Tajudin Ibnu Hajar Ida Nurlinda Ika Rosyidatul Fauziyah Ikhsan Ikhsan Ilmansyah, Rafi Indra Lukmana INDRAYANI, DEWI Indri Septiani Irma Dewiyanti ISKANDAR ZULKARNAEN SIREGAR Ismail Ismail Ivan Dwi Fibrian Jaelani, Rijal Jayanti, Diana Dwi Jibril, Abubakar Muhammad Joko Pratomo, Joko Kalamillah, Achmad Muqtafin Kamal, Safwan Karlowe, Vega Khasanah, Ri’anatul Khasanah, Ulil Afidatul Kholid, Kholid Kholik, Saeful Khusna, Fitria Asmaul Kurnia, Ryzka Dwi Laina Rafianti Langkeru, Alan Yonathan Leoni Talitha Mutmainah Lies Sulistiani Luki Ardiantoro M A Tihami M. Irwan Bustami MA, Roikhan Magfiroh, Baiti Abir Manapa, Chandra Hermawan Maret Priyanta Matin, Iman Maya Brigitta Syahra Mayla Cindy Carmeliasari Miftahul Falah Miftahul Falah Miftahul Zannah Mochammad Imron Awalludin Moh. Iklil Albahij Mohamad Sofyan Harahap Mufidah, Aisya Muhamad Fauzan Halim Muhamad Thohar Arifin Muhammad Abdul Rasyid Muhammad Farhan Muhammad Haidar Al-Hafiizh Muhammad Naim Zuhaily Muhammad Rully Zen Muhammad Thohar Arifin Muthoharoh, Roihatul Mutmainah, Leoni Talitha N. Lalah Alawiyah N. Nurjanah Nada Aulia Naf'an Tarihoran Nasir, Mohammad Dendi Abdul Nawawi, Mukhshon Neni Sholihat Nitibaskara, TB Unu Nufan Balafif, Nufan Nugraha, Enung Nurul Hamdi Nurzaman, R Adi Ogi, Muhamad Ombo Satjapradja Oni Sahroni, Oni Pramono, Bayu Prayoga, Galang Eka Priambada, Dody Prihastomo, Krisna Tsaniadi Primadana, Ramadhan Jabal Purba, T. Yuliana Purnama, Noer Putri, Lusianasta Mandini Hermanto R. Benny Riyanto R. Romli, Yusuf Rahmawati, Desty Ramaditya, Mochamad Ramli, Ahmad M Raswan Raswan Raswan Raswan, Raswan Rifaudin , Ahmad Rima Lestari Rima Lestari Rizky Aryani Septarina, Faiza Romli, Ombi Rusdiana Rusdiana Rusdiyah Faruk Sa'adah, Sa'adah Saeful Kholik Safitri, Julian Dwi Safitri, Rahmad Safwan Kamal Salampessy, Messalina L. Sari, Septia Nanda Saryomo, Saryomo Satrias Apgar Sa’adah Sa’adah Sa’adah Sefia, Putri Ilma Selsabila Nur Aprillia Sianturi, Rea Sava Kinanti Sigid Suseno Singadimedja, Holyness N Sinta Dewi Sirojudin, Rumbang Siswandari Noertjahjani Siti Marhamah Soeharyo Hadisaputro Sofian Iskandar, Sofian Sri Wilarso Budi Srikandi Suharsono Suharsono Sukesi . Sulistio, Ficky Rifky Supianto Supianto, Supianto Syarifudin, Encep Taqi, Anas Zein Tarihoran, Naf’an Tasya Safiranita, Tasya Teguh Priyo Utomo Tien, Rany Titin Suhartini, Titin Topo Santoso Toto Edidarmo Tsuaibatul Islamiyah Vina Vionita Wafa, Muhammad Athoila Wati Susiawati Wicaksana, Gede Agung Patra Widya Istanto Nurcahyo Wirayanto Natanegara Aswadi Yanti, Tasya Dwi yazid hady, yazid Yoga Laksana Yuris Bakhtiar Yuriz Bakhtiar yuyun solihat Yuyun Solihatin Zaenuddin, Ahmad Zahra, Fatima El ZUBIR