Bibliographic Details
| Title: |
Cirugía resectiva en epilepsia farmacorresistente. |
| Alternate Title: |
Resective surgery in drug-resistant epilepsy. |
| Authors: |
Alonso-Vanegas, Mario A.1 alonsomario@hotmail.com, Quintero-López, Eduardo1, Sentíes-Madrid, Horacio2, San Juan-Orta, Daniel3 |
| Source: |
Revista Mexicana de Neurociencia. 2026 Supplement, Vol. 27, p196-208. 13p. |
| Abstract (English): |
Introduction: Drug-resistant epilepsy (DRE) is a condition associated with high morbidity and mortality. Resective epilepsy surgery is an effective and safe therapeutic alternative, although it remains underutilized. Objective: To synthesize the evidence on the efficacy, safety, and selection of candidates for resective epilepsy surgery, and to formulate clinical recommendations based on the GRADE approach. Method: A systematic review was conducted using the GRADE Adolopment methodology, including randomized controlled trials, systematic reviews, and meta-analyses. A PICOS-based search strategy was applied in Embase to identify relevant evidence. Results: Resective surgery, particularly in temporal lobe epilepsy, demonstrated greater efficacy in seizure control (≈ 60-75%) compared with medical treatment (< 10%), along with improvements in quality of life. Factors such as the presence of a lesion on MRI, EEG-imaging concordance, and complete resection were associated with better outcomes. Surgical mortality was low (< 1%), and adverse events were generally manageable. Conclusions: Resective epilepsy surgery is an effective and safe intervention in selected patients with DRE. Early referral and multidisciplinary evaluation optimize clinical outcomes. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
Introducción: La epilepsia farmacorresistente (ERF) es una condición con alta morbilidad y mortalidad. La cirugía resectiva de epilepsia es una alternativa terapéutica efectiva y segura, aunque tradicionalmente infrautilizada. Objetivo: Sintetizar la evidencia sobre eficacia, seguridad y selección de candidatos para cirugía resectiva de epilepsia, y formular recomendaciones clínicas basadas en el enfoque GRADE. Método: Se realizó una revisión sistemática utilizando GRADE Adolopment, incluyendo ensayos clínicos aleatorizados, revisiones sistemáticas y metaanálisis. Se utilizó estrategia PICOS en Embase para identificar evidencia relevante. Resultados: La cirugía resectiva, especialmente en epilepsia del lóbulo temporal, demostró mayor eficacia en el control de crisis (≈ 60-75%) comparada con el tratamiento médico (< 10%) y mejoría en calidad de vida. Factores como lesión visible en IRM, concordancia EEG-imagen y resección completa se asocian a mejores resultados. La mortalidad quirúrgica es baja (< 1%) y eventos adversos son generalmente manejables. Conclusiones: La cirugía resectiva de epilepsia es una intervención efectiva y segura en pacientes seleccionados con ERF. La referencia temprana y evaluación multidisciplinaria optimizan los resultados clínicos. [ABSTRACT FROM AUTHOR] |
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| Database: |
MedicLatina |
