ArticleEpileptic disorders : international epilepsy journal with videotape2026
Does classical semiology ("5As") predict post-operative seizure outcome in patients with temporal lobe epilepsy?
Article in Epileptic disorders : international epilepsy journal with videotape, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTemporal lobe epilepsy (TLE) accounts for 50%-70% of cases referred for epilepsy surgery. This study was designed to evaluate the distribution of the five hallmark seizure features-antecedent, aura, arrest, automatisms, and amnesia-considered collectively as the "5As," in individuals with temporal lobe epilepsy. We also analyzed the prognostic significance of 5As, if any, in predicting surgical outcome in drug-resistant TLE patients.
methodsWe included 684 patients who underwent clinical evaluation, neuropsychological assessment, high-resolution MRI, and VEEG monitoring followed by standard anterior temporal lobectomy between January 2009 and December 2018. Patients were followed up at 3, 12, and 36 months, and yearly thereafter after surgery. Outcomes were classified as "good" if patients remained seizure and aura-free, irrespective of medication, and "poor" if seizures of any type recurred post-operatively. The predictors determining the outcomes were analyzed using logistic regression, and Kaplan-Meier curves assessed the long-term seizure-free survival.
resultsA total of 8456 VEEGs were done during this time period. Of them, 1747 were focal epilepsies; TLE were 1068, and surgical management was opted in 709 of them, of whom 684 patients formed this study cohort; 93.7% exhibited behavioral arrest, 88.6% had automatisms, 86.7% experienced amnesia, 74.6% reported auras, and 63.6% had antecedents (initial precipitating injury). All the classic semiological features (5 As) were present in 37.7%. At last follow-up, 47.8% had a good outcome at a mean follow-up of 75.6 months (maximum 14 years). Febrile seizures were associated with better seizure outcome (p = .021). Encephalitis (p = .026) and behavioral arrest (p = .006) were associated with poor outcome. No significant association was found between the presence of aura(s), automatisms, or amnesia with post-operative outcome.
conclusionA history of febrile seizures was linked to better post-operative outcomes, whereas encephalitis and behavioral arrest were associated with poorer prognosis. The presence or absence of any combination of classic features (5As) did not significantly affect the success of anterior temporal lobectomy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.