Back to Search
Start Over
Long-term seizure outcome in frontal lobe epilepsy surgery
- Source :
- Epilepsybehavior : EB. 90
- Publication Year :
- 2018
-
Abstract
- Purpose The purpose of this study was to report long-term seizure outcome in patients who underwent frontal lobe epilepsy (FLE) surgery. Method This retrospective study included 44 consecutive subjects who underwent resective surgery for intractable FLE at IRCCS NEUROMED (period 2001–2014), followed up for at least 2 years (mean: 8.7 years). All patients underwent noninvasive presurgical evaluation and/or invasive electroencephalography (EEG) monitoring when nonconcordant data were obtained or epileptogenic zone was hypothesized to be close to the eloquent cortex. Electroclinical, neuroimaging, surgical data, and histology were compared to seizure outcome. Results Mean epilepsy duration was 19 years; mean age at surgery was 31.6 years. Preoperative magnetic resonance imaging (MRI) showed a frontal lesion in 86.4 % of cases. Scalp video-electroencephalography (VEEG) monitoring detected a focal ictal onset in 90% of cases. Twenty-seven patients (61.4%) underwent invasive recordings. Resections involved dorsolateral (47.7%), medial (9%), orbital (13.6%), and rolandic (13.6%) region. Lobectomy within functional boundaries was performed in the remaining 7 cases (16%). Transient and permanent neurological deficits were observed in 2 and 3 cases, respectively. Histology revealed focal cortical dysplasia (45.5%), World Health Organization (WHO) I–II grade tumors (15.9%), gliosis (22.7%), vascular malformations (4.5%), Rasmussen encephalitis (6.8%), and normal tissue (4.5%). At last observation 68.1% of patients were in Engel's class I, 11.4% in class II, 9% in class III, and 11.4% in class IV. A favorable outcome was associated with focal ictal scalp EEG onset (p = 0.0357). Conclusion Surgery is a safe treatment option in drug-resistant FLE with a satisfying long-term outcome. These data highlight the importance of an appropriate selection of potential surgical candidates.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Epilepsy, Frontal Lobe
Electroencephalography
03 medical and health sciences
Behavioral Neuroscience
Epilepsy
Young Adult
0302 clinical medicine
Seizures
medicine
Humans
Epilepsy surgery
Ictal
030212 general & internal medicine
Child
Retrospective Studies
Cerebral Cortex
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Cortical dysplasia
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Psychosurgery
medicine.anatomical_structure
Treatment Outcome
Neurology
Frontal lobe
Scalp
Female
Neurology (clinical)
Radiology
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 15255069
- Volume :
- 90
- Database :
- OpenAIRE
- Journal :
- Epilepsybehavior : EB
- Accession number :
- edsair.doi.dedup.....56932e4d804b5a37a1005d6dc7382665