Outcome ed eventi avversi in pazienti con epilessia parziale farmacoresistente sottoposti a chirurgia resettiva dopo esplorazione con elettrodi subdurali

Translated title of the contribution: Surgery after intracranial investigation with subdural electrodes in patients with drug-resistant focal epilepsy: Outcome and complications

A. Mascia, R. Morace, G. Di Gennaro, P. P. Quarato, A. Picardi, A. Sparano, A. D'Aniello, N. G. Meldolesi, L. Grammaldo, M. De Risi, V. Esposito

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. Video-EEG monitoring with intracranial subdural electrodes is a useful assessment tool for the localizazion of the epileptogenic zone in patients with drug-resistant focal epilepsy. The aim of this study was to assess the surgical outcome and morbidity in patients who underwent epilepsy surgery after intracranial EEG monitoring. Methods. We studied all consecutive patients (n=58, mean age 30.4±3.5; n=44 with preoperatively detected structural lesion) admitted to our Epilepsy Surgery Centre who underwent surgery after intracranial monitoring with subdural electrodes and were followed up for at least 2 years. Results. Postoperative transient neurological deficits occurred in 5 cases, while another patient experienced lateral homonymous hemianopia. Extraoperative ECoG allowed the identification of the epileptogenic focus in all cases. The temporal lobe was involved in 21 patients (36%), whereas extra-temporal foci were identified in 24 patients (41%). Thirteen patients (23%) had multilobar involvement. Among patients with evidence of lesion on preoperative MRI, lesionectomy alone was performed in 12 cases (27%) while it was combined with tailored cortical resection in the remaining cases. Tailored cortical resection was also performed in the patients without evidence of lesion on MRI. Fifty-seven percent of patients are seizure-free (Engel's class I) 2 years after surgery, while other 8 patients (14%) experience only rare seizures (Engel's class II). Conclusions. This study suggests that invasive EEG recording with subdural electrodes may be useful for many candidates for epilepsy surgery, as it turned out to be fairly safe and allowed the identification of the epileptogenic zone in all patients, and adequate functional brain mapping when required.

Translated title of the contributionSurgery after intracranial investigation with subdural electrodes in patients with drug-resistant focal epilepsy: Outcome and complications
Original languageItalian
Pages (from-to)59-64
Number of pages6
JournalBollettino - Lega Italiana contro l'Epilessia
Issue number145
Publication statusPublished - Apr 2013

ASJC Scopus subject areas

  • Clinical Neurology

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