Akademik Veri Yönetim Sistemi
31st International Epilepsy Congress, İstanbul, Türkiye, 5 - 09 Eylül 2015, cilt.56, ss.218, (Özet Bildiri)
Purpose: Accurate delineation of epileptogenic zone is crucial before
epilepsy surgery, however non-invasive presurgical evaluation may not
provide adequate data. Therefore invasive electroencephalography monitoring (IEM) is needed in selected patients. In this study, we aimed to
investigate electro-clinical characteristics and long-term outcome of our
case series with IEM.
Method: Patients who were admitted to our Clinical Neurophysiology
Division-Epilepsy Unit and underwent IEM between 2003 and 2014 are
included in this retrospective study.
Results: Sixty patients (32 Males/28 Females) with mean age of
29.7 9.6 (5–50 years) were included. Mean age at seizure onset and
time of IEM were 9.5 8.3 and 24.3 9.4 years, respectively. Cranial
MRIs of 14 patients were normal, while FDG-PET showed hypometabolism. FDG-PET was normal in two patients, while MRI showed lesions
and in four patients both MRI and FDG-PET findings were negative.
Subdural electrodes were implanted in 35, depth electrodes in 14, and
combined electrodes in 6 patients (data not available (N/A): 5 patients).
Apart from non-operated 2 patients, 53 cases underwent lobectomy, one
had hemispherectomy (N/A: 4 patients), and 5 cases were re-operated.
Eight patients had hippocampal sclerosis, 32 had focal cortical dysplasia
(13: type-1, 19: type-2), other etiologies such as polymicrogyria/reactive
gliosis were defined in 12 cases (N/A: 6 patients). Postoperative complications including focal neurological deficits/hemorrhage, which were
transient observed in nine patients. Antiepileptic drug therapy was discontinued postoperatively in 4 patients (7%) and decreased to monotherapy in 18 patients (31%). Postoperative follow-up was 6.3 2.8 years.
On the last follow-up visit, 30 patients are Engel-I (52%), 12 patients
Engel-II (21%), 12 cases Engel-III (21%), and 4 patients Engel-4 (7%).
Conclusion: Favorable results are still possible in patients, whose
epileptogenic zone cannot be described by non-invasive techniques during presurgical evaluation. Majority of our patients, who needed IEM
had FCD or were MRI negative. In carefully selected patients with medically refractory epilepsy, IEM provides critical information before surgery and increases success rate.