Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis

Bibliographic Details
Main Author: Baldauf,Cristine Mella
Publication Date: 2006
Other Authors: Cukiert,Arthur, Argentoni,Meire, Baise-Zung,Carla, Forster,Cássio Roberto, Mello,Valeria Antakli, Burattini,José Augusto, Mariani,Pedro Paulo, Câmara,Ródio Brandão, Seda,Lauro
Format: Article
Language: eng
Source: Arquivos de neuro-psiquiatria (Online)
Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000300003
Summary: 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 Engel’s 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 Engel’s 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.
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spelling Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosisrefractory temporal lobe epilepsyhippocampal sclerosissurgeryelectroencephalographymagnetic resonance imageINTRODUCTION: 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 Engel’s 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 Engel’s 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.Academia Brasileira de Neurologia - ABNEURO2006-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000300003Arquivos de Neuro-Psiquiatria v.64 n.2b 2006reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/S0004-282X2006000300003info:eu-repo/semantics/openAccessBaldauf,Cristine MellaCukiert,ArthurArgentoni,MeireBaise-Zung,CarlaForster,Cássio RobertoMello,Valeria AntakliBurattini,José AugustoMariani,Pedro PauloCâmara,Ródio BrandãoSeda,Lauroeng2006-08-02T00:00:00Zoai:scielo:S0004-282X2006000300003Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2006-08-02T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse
dc.title.none.fl_str_mv Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
title Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
spellingShingle Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
Baldauf,Cristine Mella
refractory temporal lobe epilepsy
hippocampal sclerosis
surgery
electroencephalography
magnetic resonance image
title_short Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
title_full Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
title_fullStr Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
title_full_unstemmed Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
title_sort Surgical outcome in patients with refractory epilepsy associated to MRI-defined unilateral mesial temporal sclerosis
author Baldauf,Cristine Mella
author_facet Baldauf,Cristine Mella
Cukiert,Arthur
Argentoni,Meire
Baise-Zung,Carla
Forster,Cássio Roberto
Mello,Valeria Antakli
Burattini,José Augusto
Mariani,Pedro Paulo
Câmara,Ródio Brandão
Seda,Lauro
author_role author
author2 Cukiert,Arthur
Argentoni,Meire
Baise-Zung,Carla
Forster,Cássio Roberto
Mello,Valeria Antakli
Burattini,José Augusto
Mariani,Pedro Paulo
Câmara,Ródio Brandão
Seda,Lauro
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Baldauf,Cristine Mella
Cukiert,Arthur
Argentoni,Meire
Baise-Zung,Carla
Forster,Cássio Roberto
Mello,Valeria Antakli
Burattini,José Augusto
Mariani,Pedro Paulo
Câmara,Ródio Brandão
Seda,Lauro
dc.subject.por.fl_str_mv refractory temporal lobe epilepsy
hippocampal sclerosis
surgery
electroencephalography
magnetic resonance image
topic refractory temporal lobe epilepsy
hippocampal sclerosis
surgery
electroencephalography
magnetic resonance image
description 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 Engel’s 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 Engel’s 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.
publishDate 2006
dc.date.none.fl_str_mv 2006-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000300003
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000300003
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0004-282X2006000300003
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
dc.source.none.fl_str_mv Arquivos de Neuro-Psiquiatria v.64 n.2b 2006
reponame:Arquivos de neuro-psiquiatria (Online)
instname:Academia Brasileira de Neurologia
instacron:ABNEURO
instname_str Academia Brasileira de Neurologia
instacron_str ABNEURO
institution ABNEURO
reponame_str Arquivos de neuro-psiquiatria (Online)
collection Arquivos de neuro-psiquiatria (Online)
repository.name.fl_str_mv Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia
repository.mail.fl_str_mv ||revista.arquivos@abneuro.org
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