التفاصيل البيبلوغرافية
| العنوان: |
Intraoperative Magnetic-Resonance Tomography and Neuronavigation During Resection of Focal Cortical Dysplasia Type II in Adult Epilepsy Surgery Offers Better Seizure Outcomes. |
| المؤلفون: |
Roessler, Karl1 karl.roessler@uk-erlangen.de, Kasper, Burkhard S.2, Heynold, Elisabeth1, Coras, Roland3, Sommer, Björn1, Rampp, Stefan1, Hamer, Hajo M.2, Blümcke, Ingmar3, Buchfelder, Michael1 |
| المصدر: |
World Neurosurgery. Jan2018, Vol. 109, pe43-e49. 1p. |
| مصطلحات موضوعية: |
*EPILEPSY surgery, *INTRAOPERATIVE care, *MAGNETIC resonance imaging, *PARTIAL epilepsy, *SURGICAL excision |
| مستخلص: |
Objective Focal cortical dysplasia (FCD) is one important cause of drug-resistant epilepsy potentially curable by epilepsy surgery. We investigated the options of using neuronavigation and intraoperative magnetic-resonance tomographical imaging (MRI) to avoid residual epileptogenic tissue during resection of patients with FCD II to improve seizure outcome. Methods Altogether, 24 patients with FCD II diagnosed by MRI (16 female, 8 male; mean age 34 ± 10 years) suffered from drug-resistant electroclinical and focal epilepsy for a mean of 20.7 ± 5 years. Surgery was performed with preoperative stereoelectroencephalography (in 15 patients), neuronavigation, and intraoperative 1.5T-iopMRI in all 24 investigated patients. Results In 75% of patients (18/24), a complete resection was performed. In 89% (16/18) of completely resected patients, we documented an Engel I seizure outcome after a mean follow-up of 42 months. All incompletely resected patients had a worse outcome (Engel II-III, P < 0.0002). Patients with FCD IIB had also significant better seizure outcome compared with patients diagnosed as having FCD IIA (82% vs. 28%, P < 0.02). In 46% (11/24) of patients, intraoperative second-look surgeries due to residual lesions detected during the intraoperative MRI were performed. In these 11 patients, there were significant more completely seizure free patients (73% vs. 38% Engel IA), compared with 13 patients who finished surgery after the first intraoperative MRI ( P < 0.05). Conclusions Excellent seizure outcome after surgery of patients with FCD II positively correlated with the amount of resection, histologic subtype, and the use of intraoperative MRI, especially when intraoperative second-look surgeries were performed. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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