Resection of frontal encephalomalacias for intractable epilepsy: outcome and prognostic factors

Epilepsia
N J KazemiF W Sharbrough

Abstract

Because focal encephalomalacia is an important cause of medically intractable partial epilepsy and few studies have evaluated the efficacy and the safety of resecting focal-encephalomalacias to improve seizure control, we studied a cohort of 17 consecutive patients who underwent resection of encephalomalacias in the frontal lobes as a treatment of their intractable epilepsy. We evaluated several factors for their value in predicting postsurgical seizure control. Pre- and postsurgical magnetic resonance imaging (MRI) scans were reviewed independently by 2 blinded investigators. At a median of 3 years of follow-up (range 0.6-7.5 years), 12 patients (70%) were seizure-free or had only rare seizures. The presence of a focal fast frequency discharge (focal ictal beta pattern) at the beginning of seizures on scalp EEG was predictive of seizure-free outcome (p = 0.017), even among patients who had complete resection of their encephalomalacias (p = 0.016). There was no significant differences in outcome with regard to age at the time of the injury that caused encephalomalacia, interval between injury and onset of seizures, duration of presurgical seizure history, presurgical seizure frequency, age at surgery, or the completeness of enc...Continue Reading

References

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Citations

Jul 13, 2006·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ricardo Silva CentenoSergio Cavalheiro
Aug 28, 1999·Journal of the Neurological Sciences·R L Kutsy
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Jun 7, 2003·Epilepsy & Behavior : E&B·Dang NguyenSusan S Spencer
Jun 8, 1999·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·J L Thompson, J S Ebersole
Jun 24, 1998·Epilepsia·P Kotagal, G S Arunkumar
Sep 9, 2005·Epilepsia·Rakesh K GuptaPonnada A Narayana
Jul 12, 2012·Epilepsia·Stefanie P LazowBarbara C Jobst
Mar 3, 2012·Neurosurgical Focus·Shahin HakimianGeorge A Ojemann
Mar 10, 2000·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·E L SoB P Mullan
Aug 9, 2006·Expert Review of Neurotherapeutics·Carlo Alberto Pagni, Francesco Zenga
Feb 11, 2015·Epilepsy & Behavior Case Reports·Monisha GoyalJeffrey Blount
Aug 20, 2008·Pediatric Annals·Madeliene Grigg-Damberger
Oct 18, 2005·Clinical Neurology and Neurosurgery·Amit AgrawalMurali Manju
Dec 30, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Andrei Irimia, John Darrell Van Horn
Aug 23, 2016·World Neurosurgery·Yoshua EsquenaziNitin Tandon
Jan 7, 2016·Sports Health·Teena ShettyApostolos John Tsiouris
Jun 5, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jonathan PindrikCurtis J Rozzelle

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