Principles of Invasive EEG

Cortical Dysplasia ◽

Palliative Surgery ◽

Mesial Temporal Sclerosis ◽

Choice Of Technique ◽

Inappropriate Choice

The growing requirement for invasive EEG in presurgical evaluation of intractable focal epilepsy has been driven largely by the increasing complexity of epilepsy surgery cases. Extratemporal surgeries now exceed anterior temporal lobe resections for mesial temporal sclerosis, and the proportion of patients undergoing invasive EEGs has significantly increased. Half of all patients undergoing stereotactic EEG (SEEG) evaluations are MRI-negative (usually with focal cortical dysplasia type 1 or 2) and a third are reoperations for failed resective or palliative surgery. Certain principles guide the decision to use invasive EEG and the choice of invasive EEG technique. SEEG has distinct advantages, as do subdural grid evaluations and intraoperative corticography. The consequences of loose hypotheses in the decision to invasively evaluate a patient, and of inappropriate choice of technique, include poor seizure outcomes after surgery, morbidity, and mortality. This chapter discusses the guiding principles for invasive studies of the human epileptic brain.

Applications of Intraoperative Ultrasound in Epilepsy Surgery for Focal Cortical Dysplasia

Journal of Medical Ultrasound ◽

10.1016/j.jmu.2014.02.004 ◽

2014 ◽

Vol 22 (1) ◽

pp. 43-46 ◽

Cited By ~ 5

Author(s):

Cheng-Chia Lee ◽

Chun-Fu Lin ◽

Hsiang-Yu Yu ◽

Sheng-Che Hung ◽

Yang-Hsin Shih ◽

...

Keyword(s):

Epilepsy Surgery ◽

Intraoperative Ultrasound ◽

Focal Cortical Dysplasia in Temporal Lobe Epilepsy

Magnetic Resonance Scanning and Epilepsy ◽

10.1007/978-1-4615-2546-2_20 ◽

1994 ◽

pp. 111-116

Author(s):

R. Kuzniecky

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Neuropathology of Temporal Lobe Epilepsy

Epilepsy Research and Treatment ◽

10.1155/2012/624519 ◽

2012 ◽

Vol 2012 ◽

pp. 1-13 ◽

Cited By ~ 6

Author(s):

Fahd Al Sufiani ◽

Lee Cyn Ang

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Cortical Dysplasia ◽

Wide Range ◽

Pathologic Findings ◽

Pathologic Lesions ◽

Recent Classification ◽

Associated Tumors

Pathologic findings in surgical resections from patients with temporal lobe epilepsy include a wide range of diagnostic possibilities that can be categorized into different groups on the basis of etiology. This paper outlines the various pathologic entities described in temporal lobe epilepsy, including some newly recognized epilepsy-associated tumors, and briefly touch on the recent classification of focal cortical dysplasia. This classification takes into account coexistent pathologic lesions in focal cortical dysplasia.

Coregistrating magnetic source and magnetic resonance imaging for epilepsy surgery in focal cortical dysplasia

NeuroImage Clinical ◽

10.1016/j.nicl.2018.04.034 ◽

2018 ◽

Vol 19 ◽

pp. 487-496 ◽

Cited By ~ 8

Author(s):

Burkhard S. Kasper ◽

Karl Rössler ◽

Hajo M. Hamer ◽

Arnd Dörfler ◽

Ingmar Blümcke ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Epilepsy Surgery ◽

Cortical Dysplasia ◽

Resonance Imaging ◽

Magnetic Source

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

P.015 Mesial Temporal Sclerosis is a rare occurrence in Intractable Pediatric Temporal Lobe Epilepsies

10.1017/cjn.2018.117 ◽

2018 ◽

Vol 45 (s2) ◽

pp. S19-S19

Author(s):

J Kassiri ◽

T Rajapakse ◽

L Schmitt ◽

M Wheatley ◽

B Sinclair

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Pediatric Patients ◽

Surgical Pathology ◽

Pediatric Epilepsy ◽

Mesial Temporal Sclerosis ◽

Surgical Interventions ◽

Retrospective Cohort Studies ◽

Magnetic Resonance Imaging Mri

Background: Temporal lobe epilepsy (TLE) accounts for approximately 20% of pediatric epilepsy cases. Of those, many are considered medically intractable and require surgical interventions. In this study, we hypothesized that mesial temporal sclerosis (MTS) was less common in patients who had undergone surgery for intractable pediatric TLE than in adult series. We further hypothesized that there was a radiological and pathological discordance in identifying the cause of pediatric TLE. Methods: We retrospectively reviewed the charts of pediatric patients with TLE who had undergone surgical treatments as part of the University of Alberta’s Comprehensive Epilepsy Program between 1988 and 2018. Along with preoperative magnetic resonance imaging (MRI) reports, post-surgical pathology results and seizure outcomes were studied Results: Of the 83 pediatric patients who had undergone temporal lobe epilepsy surgery, 28% had tumors, 22% had dual pathologies, 18% had MTS, 11% had focal cortical dysplasia, and 22% had other pathologies. In addition, for 36% of these patients, discordance between their pre-surgical MRI reports and post-surgical pathology reports were found. Conclusions: This was one of the largest retrospective cohort studies of pediatric patients who had undergone surgery for intractable TLE. This study showed that tumors, and not MTS, were the most common pathology in surgical pediatric TLE.

Outcome of epilepsy surgery in focal cortical dysplasia

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.74.2.183 ◽

2003 ◽

Vol 74 (2) ◽

pp. 183-188 ◽

Cited By ~ 108

Author(s):

T Kral ◽

H Clusmann ◽

I Blumcke ◽

R Fimmers ◽

B Ostertun ◽

...

Keyword(s):

Epilepsy Surgery ◽

Epilepsy surgery in the setting of periventricular leukomalacia and focal cortical dysplasia

Neurology ◽

10.1212/wnl.46.3.839 ◽

1996 ◽

Vol 46 (3) ◽

pp. 839-841 ◽

Cited By ~ 27

Author(s):

E. Wyllie ◽

Y. Comair ◽

P. Ruggieri ◽

S. Raja ◽

R. Prayson

Keyword(s):

Epilepsy Surgery ◽

Periventricular Leukomalacia ◽

Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country

Epilepsy Research and Treatment ◽

10.1155/2014/286801 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8

Author(s):

Abdulaziz Alsemari ◽

Faisal Al-Otaibi ◽

Salah Baz ◽

Ibrahim Althubaiti ◽

Hisham Aldhalaan ◽

...

Keyword(s):

Temporal Lobe ◽

Epilepsy Surgery ◽

Intractable Epilepsy ◽

Research Centre ◽

Mesial Temporal Sclerosis ◽

Brain Scans ◽

Temporal Epilepsy ◽

Dual Pathology ◽

Surgery Outcome ◽

Postoperative Seizure

Purpose. To review the postoperative seizure outcomes of patients that underwent surgery for epilepsy at King Faisal Specialist Hospital & Research Centre (KFSHRC). Methods. A descriptive retrospective study for 502 patients operated on for medically intractable epilepsy between 1998 and 2012. The surgical outcome was measured using the ILAE criteria. Results. The epilepsy surgery outcome for temporal lobe epilepsy surgery (ILAE classes 1, 2, and 3) at 12, 36, and 60 months is 79.6%, 74.2%, and 67%, respectively. The favorable 12- and 36-month outcomes for frontal lobe epilepsy surgery are 62% and 52%, respectively. For both parietal and occipital epilepsy lobe surgeries the 12- and 36-month outcomes are 67%. For multilobar epilepsy surgery, the 12- and 36-month outcomes are 65% and 50%, respectively. The 12- and 36-month outcomes for functional hemispherectomy epilepsy surgery are 64.2% and 63%, respectively. According to histopathology diagnosis, mesiotemporal sclerosis (MTS) and benign CNS tumors had the best favorable outcome after surgery at 1 year (77.27% and 84.3%, resp.,) and 3 years (76% and 75%, resp.,). The least favorable seizure-free outcome after 3 years occurred in cases with dual pathology (66.6%). Thirty-four epilepsy patients with normal magnetic resonance imaging (MRI) brain scans were surgically treated. The first- and third-year epilepsy surgery outcome of 17 temporal lobe surgeries were (53%) and (47%) seizure-free, respectively. The first- and third-year epilepsy surgery outcomes of 15 extratemporal epilepsy surgeries were (47%) and (33%) seizure-free. Conclusion. The best outcomes are achieved with temporal epilepsy surgery, mesial temporal sclerosis, and benign CNS tumor. The worst outcomes are from multilobar surgery, dual pathology, and normal MRI.