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Cortical Resections in Drug Resistant Epilepsy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04553354
Recruitment Status : Not yet recruiting
First Posted : September 17, 2020
Last Update Posted : September 17, 2020
Sponsor:
Information provided by (Responsible Party):
Mahmoud Ammar, Assiut University

Brief Summary:
The aim of the study is to evaluate safety and efficacy of epilepsy surgery in the form of cortical resections in patients with refractory epilepsy and to review outcomes of resection procedures in focal epilepsy.

Condition or disease Intervention/treatment
Epilepsy Surgery Drug Resistant Epilepsy Procedure: cortical resections

Detailed Description:

Nearly one-third of epilepsy patients are refractory/resistant to medical treatment . Refractory or drug-resistant epilepsy is defined as resistance to treatment with two appropriately chosen and tolerated antiepileptic drugs (AED) . Nevertheless, epilepsy surgery is an effective alternative treatment for some patients as it suggests seizure freedom . During the past 3 decades, surgery has found more acceptance as an option for drug-resistant epilepsy . Developments made in surgical techniques (cortical resections) have significantly increased the effectiveness and safety of these techniques; as such techniques have been demonstrated to improve seizure control/freedom outcomes and enhanced quality of life in patients . Neuro imaging developments with the introduction of positron emission tomography (PET), magnetic resonance imaging (MRI), functional MRI, single-photon emission computed tomography (SPECT), and magneto encephalography, electroencephalography and neuronavigation have facilitated the presurgical evaluation of patients, thus providing the lesion-directed surgeries more possible , also reducing the number and severity of complications . Complications of epilepsy surgery including failure to stop seizures and neuropsychological, psychosocial, or psychiatric impairment are still difficult to define, and there is no universal consensus in this regard .

This technique characterized by :

• Once the epilepsy focus is located by using interpretation and collection of data from functional MRI, EEG long term video and clinical findings, the specific surgery involved in treatment is decided on. The type of surgery depends on the location of the seizure focal point. Surgeries for epilepsy treatment include, but are not limited to, the following types: temporal lobe resection, ground temporal and extra temporal resection, parietal resection, occipital resection, frontal resection, extra temporal resection.

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Study Type : Observational
Estimated Enrollment : 35 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Evaluation of Safety and Efficacy of Cortical Resections for Seizure Control for Patients With Drug Resistant Epilepsy
Estimated Study Start Date : September 10, 2020
Estimated Primary Completion Date : September 10, 2022
Estimated Study Completion Date : November 10, 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Epilepsy Medicines


Intervention Details:
  • Procedure: cortical resections
    is the removal of the epileptic focus either temporal or extra temporal area


Primary Outcome Measures :
  1. control of focal epilepsy in drug resistant epileptic patients [ Time Frame: baseline ]
    seizure freedom after cortical resections will be measured by angel classification

  2. decrease incidence of drug adverse effects in drug resistant focal epilepsy [ Time Frame: baseline ]
    the well known adverse effects of AEDs that are mentioned in literature as affection of the liver and kidney will be measured preoperatively by kidney function and liver function tests to detect if it is normal or not


Secondary Outcome Measures :
  1. change quality of life of patients with drug resistant epilepsy [ Time Frame: baseline ]
    changing quality of life of those patients as regards socioeconomic status of the patients if they get a jop or not and remain in his jop or not and the financial status improved or not and all of this will be mentioned by the patients in follow up in out patient clinic



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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
all patients with focal epilepsy not responding to medical treatment
Criteria

Inclusion Criteria:

  • All patients with focal epilepsy who are refractory to medical treatment.
  • Patients accept surgical maneuver

Exclusion Criteria:

  • Epileptic patients responding to medical treatment.
  • Patients refusing surgical intervention.
  • Patients unfit for brain surgery.
  • Multi focal or generalized seizures.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04553354


Contacts
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Contact: mahmoud mostafa ammar, assistant lecturer +201026998340 dr.mahmoud.ammar90@gmail.com
Contact: Radwan Noby Mahmoud, professor +201224480595 hannahomar@yahoo.com

Sponsors and Collaborators
Assiut University
Publications:

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Responsible Party: Mahmoud Ammar, principal investigator, Assiut University
ClinicalTrials.gov Identifier: NCT04553354    
Other Study ID Numbers: epilepsy surgery
First Posted: September 17, 2020    Key Record Dates
Last Update Posted: September 17, 2020
Last Verified: September 2020

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Epilepsy
Drug Resistant Epilepsy
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases