Excessively elevated C-reactive protein after surgery for temporal lobe epilepsy

Clin Neurol Neurosurg. 2013 Aug;115(8):1245-9. doi: 10.1016/j.clineuro.2012.11.025. Epub 2012 Dec 23.

Abstract

Objective: We present a series of 87 patients who underwent anteromesial temporal lobe resections for therapy refractory temporal lobe epilepsy. In addition to seizure outcome, we observed excessively elevated CRP-levels in this patient population.

Methods: We followed 87 patients (m=39, f=48; mean age 33.73±12.92, range 5-67 years) who underwent surgery between July 2003 and November 2011. Seizure outcome was classified in all patients according to the ILAE-classification by Wieser et al. (mean follow-up: 38.72 months). CRP levels were measured in 59 patients of the epilepsy surgery group and in a control group of 44 consecutive patients with supratentorial tumors (22 glioblastomas, 22 meningiomas).

Results: Clinical benefit was seen in 96.6% of the patients (ILAE classes 1-4), 80.5% were completely seizure free (ILAE class 1). Post-OP CRP values were significantly higher in the epilepsy group (n=59; mean CRP peak value: 100.86 mg/l, range: 16-258 mg/l) compared to the control group (n=44; mean CRP peak value: 36.85 mg/l, range: 0.4-233 mg/l) (p<0.001), but the correlation of mean CRP value and mean temperature peak is weak (r=0.31).

Conclusions: Seizure outcome after surgery for temporal lobe epilepsy was excellent, CRP levels were excessively elevated in these patients in the absence of clinical infection and significantly higher compared to resections of supratentorial lesions.

Keywords: Amygdalohippocampectomy; C-reactive protein; Circumventricular organs; Neurosurgery; Seizure outcome; Therapy refractory epilepsy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amygdala / surgery
  • Anticonvulsants / therapeutic use
  • Brain Chemistry
  • C-Reactive Protein / metabolism*
  • Child
  • Child, Preschool
  • Drug Resistance
  • Epilepsy, Temporal Lobe / surgery*
  • Female
  • Hippocampus / surgery
  • Humans
  • Inflammation / pathology
  • Kinetics
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Neurosurgical Procedures / adverse effects*
  • Postoperative Complications / metabolism*
  • Retrospective Studies
  • Seizures / drug therapy
  • Seizures / epidemiology
  • Supratentorial Neoplasms / surgery
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants
  • C-Reactive Protein