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Long-term epilepsy ...
Long-term epilepsy surgery outcomes in patients with MRI-negative temporal lobe epilepsy
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Immonen, Arto (författare)
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Jutila, Leena (författare)
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Muraja-Murro, Anu (författare)
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Mervaala, Esa (författare)
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Aikia, Marja (författare)
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Lamusuo, Salla (författare)
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Kuikka, Jyrki (författare)
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Vanninen, Esko (författare)
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- Alafuzoff, Irina (författare)
- Uppsala universitet,Institutionen för genetik och patologi
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Ikonen, Aki (författare)
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Vanninen, Ritva (författare)
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Vapalahti, Matti (författare)
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Kalviainen, Reetta (författare)
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(creator_code:org_t)
- 2010-09-24
- 2010
- Engelska.
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Ingår i: Epilepsia. - : Wiley. - 0013-9580 .- 1528-1167. ; 51:11, s. 2260-2269
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- PURPOSE: The outcome of surgery in patients with temporal lobe epilepsy (TLE) and normal high-resolution magnetic resonance imaging (MRI) has been significantly worse than in patients with unilateral hippocampal damage upon MRI. The purpose of this study was to determine the long-term outcomes of consecutive true MRI-negative TLE patients who all underwent standardized preoperative evaluation with intracranial electroencephalography (EEG) electrodes. METHODS: In this study we present all adult MRI-negative TLE surgery candidates evaluated between January 1990 and December 2006 at Kuopio Epilepsy Center in Kuopio University Hospital, which provides a national center for epilepsy surgery in Finland. During this period altogether 146 TLE surgery candidates were evaluated with intracranial electrodes, of whom 64 patients with normal high-resolution MRI were included in this study. RESULTS: Among the 38 patients who finally underwent surgery, at the latest follow-up (mean 5.8 years), 15 (40%) were free of disabling seizures (Engel class I) and 6 (16%) were seizure-free (Engel class IA). Twenty-one (55%) of 38 patients had poor outcomes (Engel class III-IV). Outcomes did not change compared to 12-month follow-up. Histopathologic examination failed to reveal any focal pathology in 68% of our MR-negative cases. Only patients with noncongruent positron emission tomography (PET) results had worse outcomes (p = 0.044). DISCUSSION: Our results suggest that epilepsy surgery outcomes in MRI-negative TLE patients are comparable with extratemporal epilepsy surgery in general. Seizure outcomes in the long-term also remain stable. Modern imaging techniques could further improve the postsurgical seizure-free rate. However, these patients usually require chronic intracranial EEG evaluation to define epileptogenic areas.
Nyckelord
- Epilepsy surgery
- Temporal lobe
- Nonlesional MRI
- Outcomes
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
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Immonen, Arto
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Jutila, Leena
-
Muraja-Murro, An ...
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Mervaala, Esa
-
Aikia, Marja
-
Lamusuo, Salla
-
visa fler...
-
Kuikka, Jyrki
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Vanninen, Esko
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Alafuzoff, Irina
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Ikonen, Aki
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Vanninen, Ritva
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Vapalahti, Matti
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Kalviainen, Reet ...
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visa färre...
- Artiklar i publikationen
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Epilepsia
- Av lärosätet
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Uppsala universitet