Improved resection in lesional temporal lobe epilepsy surgery using neuronavigation and intraoperative MR imaging: favourable long term surgical and seizure outcome in 88 consecutive cases

Seizure : the Journal of the British Epilepsy Association
Karl RoesslerM Buchfelder

Abstract

To investigate the value of intraoperative MR imaging (iopMRI) combined with neuronavigation to avoid intraoperative underestimation of the resection amount during surgery of lesional temporal lobe epilepsy (LTLE) patients. We retrospectively investigated 88 patients (40 female, 48 male, mean age 37.2 yrs, from 12 to 69 yrs, 41 left sided lesions) with LTLE operated at our department, including 40.9% gangliogliomas (GG), 26.1% cavernomas (CM), 10.2% dysembryoplastic neuroepithelial tumours (DNT) and 11.4% focal cortical dysplasias (FCD), excluding hippocampal sclerosis. Complete resection was achieved in 85 of 88 patients (96.6%), as proven by postoperative MRI 6 months after surgery. In contrast, the routine first iopMR imaging before closure revealed radical resection in only 66 of these 88 patients (75%). After re-intervention, the second iopMR imaging demonstrated complete resection in 19 more patients. Thus, as a direct effect of iopMRI and neuronavigation, overall resection rate was increased by 21.6%. An excellent seizure outcome Engel Class I was found in 76.1% of patients during a mean follow-up of 26.4 months, irrespective of histological entity (74% in CM, 75% in GG, 78% in DNT and 60% in FCD). No severe postoperativ...Continue Reading

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Citations

Sep 13, 2015·Seizure : the Journal of the British Epilepsy Association·Daniele Kanashiro SonvensoLauro Wichert-Ana
Apr 7, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Matthew F SacinoChima O Oluigbo
Aug 12, 2015·Clinical Neuroradiology·S BisdasM S Tatagiba
Feb 11, 2015·British Journal of Neurosurgery·Nilesh S KurwaleManjari Tripathi
Feb 27, 2016·Journal of Neurosurgery. Pediatrics·Matthew F SacinoChima O Oluigbo
Jul 26, 2014·AJNR. American Journal of Neuroradiology·A F ChoudhriF A Boop
Apr 6, 2017·World Neurosurgery·Rami James N AounBernard R Bendok
Apr 1, 2020·Epilepsia·Christian DorferArthur Cukiert
Aug 11, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Cameron EnglmanJoseph Yuan-Mou Yang

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