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Seizure outcome after epilepsy surgery in patients with normal preoperative MRI
- Source :
- Journal of Neurology, Neurosurgery & Psychiatry. 76:710-713
- Publication Year :
- 2005
- Publisher :
- BMJ, 2005.
-
Abstract
- Objective: To determine outcome after epilepsy surgery in patients with normal preoperative magnetic resonance imaging (MRI). Methods: 24 adult and paediatric patients with normal preoperative MRIs were studied. They underwent epilepsy surgery between 1994 and 2001 and had at least one year of follow up. Results: At the most recent follow up, nine patients (37%) were seizure-free and 18 (75%) had at least a 90% reduction in seizure frequency with weekly or monthly seizures. Seizure freedom was not significantly different after resections in frontal (5/9) or temporal regions (4/13) (p = 0.24, Fisher's exact test), or among patients with or without localising features on EEG, PET, or ictal SPECT. Subdural grids, used in 15 of 24 patients, helped tailor resections but were not associated with differences in outcome. Histopathology showed cortical dysplasia in 10 patients (42%), non-specific findings in 13 (54%), and hippocampal sclerosis in one (4%). Cortical dysplasia was seen in seven patients with frontal resection (78%) and non-specific findings in nine (69%) with temporal resection. Seizure outcome did not differ on the basis of location of resection or histopathology. Conclusions: While these results were less favourable than expected for patients with focal epileptogenic lesions seen on MRI, they represented worthwhile improvement for this patient population with high preoperative seizure burden. In this highly selected group, no single test or combination of tests further predicted postoperative seizure outcome.
- Subjects :
- Adult
Male
Paper
medicine.medical_specialty
Adolescent
Ictal-Interictal SPECT Analysis by SPM
Preoperative care
Epilepsy
Preoperative Care
medicine
Humans
Epilepsy surgery
Child
Tomography, Emission-Computed, Single-Photon
Hippocampal sclerosis
medicine.diagnostic_test
business.industry
Brain
Electroencephalography
Magnetic resonance imaging
Middle Aged
Cortical dysplasia
equipment and supplies
medicine.disease
Magnetic Resonance Imaging
Surgery
Psychiatry and Mental health
Exact test
Treatment Outcome
Epilepsy, Temporal Lobe
Child, Preschool
Positron-Emission Tomography
Female
Neurology (clinical)
business
human activities
Follow-Up Studies
Subjects
Details
- ISSN :
- 00223050
- Volume :
- 76
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology, Neurosurgery & Psychiatry
- Accession number :
- edsair.doi.dedup.....9a66a8aa43e50f7087877ea61b4773e4