SEIZURE OUTCOME OF PATIENTS WITH MAGNETIC RESONANCE IMAGING-NEGATIVE EPILEPSIES: STILL AN ONGOING DEBATE

Isler C., Ozkara C., Delil M. Ş., Kayhan A., Deniz K., Akkol S., ...Daha Fazla

32nd International Epilepsy Congress, Barcelona, İspanya, 2 - 06 Eylül 2017, cilt.58, (Özet Bildiri) identifier

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 58
  • Basıldığı Şehir: Barcelona
  • Basıldığı Ülke: İspanya
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Purpose: The aim of our study is to present our surgical results and discuss clinical and histopathological parameters related to outcome in patients with MRI-negative epilepsy Method: 36 MRI-negative epilepsy patients (19 females / 17 males ) who had been evaluated for surgery at our institution between 2004 and 2016 were retrospectively analyzed. Histopathological specimens were re-rewieved by two blind neuropathologists and re-classified based on the current classifications. Seizure outcome of the patients were assessed on the basis of Engel´s classification. Results: The mean age at surgery was 24.5 years (9-51 years) and the mean seizure onset was 9.3 years (1 - 30 years). Eight patients were younger than 18 years. The Mean duration of seizures was 15.3 years (2- 41 years). All but two underwent invasive monitorisation. A total of 33 patients out of 36 were finally operated on. Eighteen patients had hypometabolism on FDG-PET with temporal lobe involvement in majority (66.7%). Hypometabolism was found in all patients with hippocampal sclerosis(HS), however it was 50 % and 66.7% in Focal Cortical Dysplasia (FCD) type I and II patients, respectively. The frontal lobe resection was the most frequent followed by temporal, parietal and occipital lobes. In 7 patients multilobar resection was necessitated. Histopathological diagnosis was FCD type I, II, III, HS, and gliosis in 14, 12, 2, 3 and 2 patients, respectively. The mean follow-up was 5.8 years (1-12 years). Seventeen patients were seizure free and favorable outcome (Engel´s I and II) was found in 69.7%. FCD type I tend to have more favorable seizure outcome. Duration of epilepsy and hypometabolism on FDG-PET was significantly related to outcome, whereas involved lobe was not. Conclusion: Results from our own experience like others, suggest that, it is worth pursuing resective surgery in adults as well as in children with drug-resistant epilepsy with normal MRI.