Detalhes bibliográficos
Autor(a) principal: |
Baldauf,Cristine Mella |
Data de Publicação: |
2006 |
Outros Autores: |
Cukiert,Arthur,
Argentoni,Meire,
Baise-Zung,Carla,
Forster,Cássio Roberto,
Mello,Valeria Antakli,
Burattini,José Augusto,
Mariani,Pedro Paulo,
Câmara,Ródio Brandão,
Seda,Lauro |
Tipo de documento: |
Artigo
|
Idioma: |
eng |
Título da fonte: |
Arquivos de neuro-psiquiatria (Online) |
Texto Completo: |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000300003
|
Resumo: |
INTRODUCTION: Several pre-operative work-up protocols have been used while selecting epileptic patients for surgery among different centers. The relative value of the different available pre-operative tests is still under discussion. OBJECTIVE: We report on the surgical outcome obtained in patients with refractory temporal lobe epilepsy associated to mesial temporal sclerosis (MTS) and who were evaluated pre-operatively by interictal EEG and MRI alone. METHOD: Forty one patients with refractory unilateral temporal lobe epilepsy were evaluated using interictal EEG and MRI. MRI disclosed unilateral MTS in all patients. All patients had at least 4 interictal EEG recordings. All patients were submitted to cortico-amygdalo-hippocampectomy at the side determined by MRI. RESULTS: Interictal EEG showed unilateral epileptiform discharges compatible with MRI findings in 37 patients; in four out of the 41 patients, bilateral discharges were found. Mean follow-up time was 4.3±1.1 years. Thirty-nine patients (95.1%) were classified as Engels Class I (70.6% Engel I-A). Two patients (4.9%) were rated as Engel's Class II. All patients in whom bilateral discharges were found were in Engels Class I. Pathological examination showed MTS in all patients. CONCLUSION: It is possible to adequately select good surgical candidates for temporal lobe resection using MRI and interictal EEG alone. In patients with MRI-defined MTS we should expect a postoperative remission rate higher then 90%. The finding of MTS on MRI is the most important good prognostic factor after temporal lobe resection. |