Patients with epileptic seizures and cerebral lesions who underwent lesionectomy restricted to or associated with the adjacent irritative area

• Autor(a) principal: Rassi Neto, Aziz [UNIFESP]
• Data de Publicação: 1999
• Outros Autores: Ferraz, Fernando Patriani [UNIFESP], Campos, Carlos R., Braga, Fernando Menezes [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/00130000125s8
• DOI: 10.1111/j.1528-1157.1999.tb00791.x
• Texto Completo: http://dx.doi.org/10.1111/j.1528-1157.1999.tb00791.x; http://repositorio.unifesp.br/handle/11600/26098
• topic: epilepsy tumors; epilepsy surgery; lesionectomy; electrocorticography

Purpose: To analyze the best surgical procedure for patients with epileptic seizures and cerebral lesions-i.e., resection restricted to the lesion or resection associated with the adjacent irritative area-based on the clinical evolution of patients' seizure outcome and electroencephalographic (EEG) and electrocorticographic (ECoG) findings.Methods: This study comprised 37 patients with epileptic seizures and cerebral lesions, ranging in age from 9 to 66 years. Patients were divided into two groups: Group 1 consisted of 21 patients with medically intractable epilepsy, Group 2 of 16 patients with medically controlled epilepsy. Eleven of the 21 patients in Group 1 (Subgroup A) underwent surgical resection of the cerebral lesion and adjacent irritative area as shown by ECoG. for the remaining 10 patients in Group 1 (Subgroup B), the resection was restricted to the lesion. the 16 patients in Group 2 all underwent lesionectomies.Results: of the 11 patients in group 1 who underwent resection of the cerebral lesion and adjacent irritative area, 91% became seizure free. Sixty percent of the remaining patients in group 1 whose resections were restricted to the lesion also became seizure free, as did all the patients in group 2. An overall analysis of the EEGs for all patients showed a statistically significant decrease in paroxysmal activity.Conclusions: in patients with uncontrolled seizures, resection of the cerebral lesion associated with the irritative area shows a tendency to obtain better seizure-outcome results than restricted lesionectomy.