Surgical treatment of mesial temporal epilepsy applying intraoperative and chronic electrocorticography (ECoG)
Abstract
Abstract. Although temporal lobe epilepsy (TLE) is the most studied form of partial epilepsy, there are still many patients with drug resistant forms. Temporal lobe surgery takes 50-73% of all epilepsy surgery and can be an effective treatment for patients whose seizures do not respond to best medical therapy. However the choice of surgical approach and extent of resection are controversial till nowadays.
Objective: to evaluate the surgical outcomes in patients with TLE using intraoperative and chronic ECoG.
Material and methods: 11 patients with TLE were included to this study. Patients with focal epilepsy caused by tumors (more than Grade 2) and AVMs were excluded. The area of temporal lobe resection was determine using intraoperative ECoG in 8 patients (40%), 3 patients (15%) underwent lobectomy determined with the help of MRI and EEG findings and at 9 patients (45%) preoperative chronic ECoG was used for surgery planning. Follow-up period was 12-36 months.
Results: Surgical outcome was evaluated according to ILAE scale, 10 patients (50%) became seizure-free and got Class 1, one patient (5%) had only 3 days per year with seizures, which is Class 3. Five patients (25%) achieved improvement after surgery and got Class 4. Four patients (20%) did not get any significant benefits from surgery and got Class 5.
Conclusion: ECoG-tailored resection provides better surgical outcome.
About the Authors
N. P. Denisova
ФГБУ Федеральный Центр нейрохирургии
Russian Federation
Russian Federation
D. Yu. Rogov
ФГБУ Федеральный Центр нейрохирургии
Russian Federation
Russian Federation
A. A. Halepa
ФГБУ Федеральный Центр нейрохирургии
Russian Federation
Russian Federation
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Review
For citations:
Denisova N.P., Rogov D.Yu., Halepa A.A. Surgical treatment of mesial temporal epilepsy applying intraoperative and chronic electrocorticography (ECoG). Russian journal of neurosurgery. 2017;(3):20-26. (In Russ.)
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