{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:52Z","timestamp":1792226572056,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Epilepsy duration is a modifiable risk factor in the outcome of definitive epilepsy surgery; however, an analogous effect in palliative procedures has not been shown. We reviewed the Pediatric Epilepsy Surgery Database data for an association between epilepsy duration and seizure reduction in palliative procedures.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients enrolled between January 2018 and April 2025 who underwent their first epilepsy surgery with palliative intent with 6\u2009months of follow\u2010up were included. Procedures included neuromodulation, corpus callosotomy, hemispherotomy, lesionectomy, and lobectomy where surgical intent was not seizure freedom. Outcomes of seizure freedom, 90% seizure reduction, and 50% seizure reduction were considered at 6\u201312\u2009months and >12\u2009months from surgery. Duration from epilepsy onset to surgery was compared for patients above and below each outcome threshold at each time point. Logistic regression analysis for the association between epilepsy duration and seizure reduction adjusted for potential confounders including procedure type, etiology, and other clinical factors. Logistic regression analysis was performed on the overall cohort and subgroups of patients with each procedure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 588 patients were included. Initial univariate analysis suggested that epilepsy duration at time of surgery was significantly associated with seizure freedom and 90% seizure reduction at both 6\u201312\u2009months and >12\u2009months. After adjusting for confounders, only seizure freedom at >12\u2009months was significantly associated with duration of epilepsy. When individual procedures were considered, only lobectomy was sensitive to duration of epilepsy in multivariate analysis, with significant impacts on >50% and >90% seizure reduction at >12\u2009months. Lesional epilepsy predicted seizure freedom at >12\u2009months. Neuromodulation and corpus callosotomy were less likely to achieve seizure reduction than other procedures.<\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n We did not find an association between early epilepsy surgery and seizure reduction. This reflects the heterogeneity of our population, including different types of surgical procedures and lesional and nonlesional epilepsies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi.70379","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:47:08Z","timestamp":1785772028000},"page":"5189-5200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of time to palliative epilepsy surgery on outcomes"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7508-196X","authenticated-orcid":false,"given":"Robert M.","family":"Crutcher","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Neurology Nemours Children's Health Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-122X","authenticated-orcid":false,"given":"David E.","family":"Horvat","sequence":"additional","affiliation":[{"name":"Department of Neurology Alexander T. Augusta Military Medical Center Ft. Belvoir Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2957-9227","authenticated-orcid":false,"given":"Avery R.","family":"Caraway","sequence":"additional","affiliation":[{"name":"Department of Neurology Jane and John Justin Institute for Mind Health, Cook Children's Medical Center Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-8331","authenticated-orcid":false,"given":"Kristen H.","family":"Arredondo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dell Medical School University of Texas at Austin Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5089-460X","authenticated-orcid":false,"given":"Taylor J.","family":"Abel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery School of Medicine, University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4684-8774","authenticated-orcid":false,"given":"Nitin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Epilepsy Minnesota Epilepsy Group Roseville Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4928-3921","authenticated-orcid":false,"given":"Allyson L.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Children's Hospital Colorado; Department of Neurosurgery University of Colorado Anschutz School of Medicine Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8395-5587","authenticated-orcid":false,"given":"Dallas Michael","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Department of Neurology University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1607-0818","authenticated-orcid":false,"given":"Kurtis I.","family":"Auguste","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of California, San Francisco Weill Institute for Neurosciences, Benioff Children's Hospital San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1077-2963","authenticated-orcid":false,"given":"Danilo","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Epilepsy University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-8722","authenticated-orcid":false,"given":"Jeffrey","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Neurology Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Neurology Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3362-0466","authenticated-orcid":false,"given":"David","family":"Bonda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Cedars\u2010Sinai Los Angeles California USA"},{"name":"Department of Pediatrics Guerin Children's, Cedars\u2010Sinai Medical Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3210-9860","authenticated-orcid":false,"given":"Dewi Frances","family":"Depositario\u2010Cabacar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Center for Neuroscience Children's National Hospital, George Washington University School of Medicine Washington District of Columbia 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