Surgical treatment of drug-resistant epilepsy following hippocampal sclerosis

ABSTRACT Neurocysticercosis is one of the most common risk factors for epilepsy but its association with drug-resistant epilepsy remains uncertain. Conjectures of an association with drug-resistant epilepsy have been fueled by reports of an association between calcific neurocysticercosis lesions (CNL) and hippocampal sclerosis (HS) from specialized epilepsy centers in Taenia solium-endemic regions. The debate arising from these reports is whether the association is causal. Evidence for the association is not high quality but sufficiently persuasive to merit further investigation with longitudinal imaging studies in population-based samples from geographically-diverse regions. The other controversial point is the choice of a surgical approach for drug-resistant epilepsy associated with CNL-HS. Three approaches have been described: standard anteromesial temporal lobectomy, lesionectomy involving a CNL alone and lesionectomy with anteromesial temporal lobectomy (for dual pathology); reports of the latter two approaches are limited. Presurgical evaluation should consider possibilities of delineating the epileptogenic zone/s in accordance with all three approaches.

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Understanding the association of neurocysticercosis and mesial temporal lobe epilepsy and its impact on the surgical treatment of patients with drug-resistant epilepsy

Epilepsy & Behavior ◽

10.1016/j.yebeh.2017.02.030 ◽

2017 ◽

Vol 76 ◽

pp. 168-177 ◽

Cited By ~ 6

Author(s):

Marino Muxfeldt Bianchin ◽

Tonicarlo Rodrigues Velasco ◽

Lauro Wichert-Ana ◽

Antonio Carlos dos Santos ◽

Américo Ceiki Sakamoto

Keyword(s):

Surgical Treatment ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Mesial Temporal Lobe Epilepsy ◽

Drug Resistant ◽

Mesial Temporal Lobe ◽

Drug Resistant Epilepsy

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Long-term quality of life after surgical treatment of drug resistant epilepsy in children

Internal Medicine Review ◽

10.18103/imr.v3i6.494 ◽

2017 ◽

Vol 3 (6) ◽

Author(s):

Paweł Daszkiewicz ◽

Anna Płachecka-Sędek

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Drug Resistant ◽

Drug Resistant Epilepsy

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HHV-7 in adults with drug-resistant epilepsy: A pathological role in hippocampal sclerosis?

Journal of Clinical Virology ◽

10.1016/j.jcv.2014.08.017 ◽

2014 ◽

Vol 61 (3) ◽

pp. 387-392 ◽

Cited By ~ 6

Author(s):

Jin-Mei Li ◽

Cheng Huang ◽

Bo Yan ◽

Wei Wang ◽

Qiao Zhou ◽

...

Keyword(s):

Hippocampal Sclerosis ◽

Drug Resistant ◽

Drug Resistant Epilepsy

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Health Technology Assessment report on the presurgical evaluation and surgical treatment of drug-resistant epilepsy

Epilepsia ◽

10.1111/epi.12309 ◽

2013 ◽

Vol 54 ◽

pp. 49-58 ◽

Cited By ~ 4

Author(s):

Carlo Efisio Marras ◽

Maria Paola Canevini ◽

Gabriella Colicchio ◽

Renzo Guerrini ◽

Guido Rubboli ◽

...

Keyword(s):

Surgical Treatment ◽

Health Technology Assessment ◽

Technology Assessment ◽

Health Technology ◽

Drug Resistant ◽

Presurgical Evaluation ◽

Assessment Report ◽

Health Technology Assessment Report ◽

Drug Resistant Epilepsy

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Unsatisfactory results of a drug resistant epilepsy surgical treatment: reasons analysis and treatment optimization way

Translational Medicine ◽

10.18705/2311-4495-2018-5-4-60-68 ◽

2018 ◽

Vol 5 (4) ◽

pp. 60-68

Author(s):

G. V. Odintsova ◽

M. V. Aleksandrov ◽

A. U. Ulitin ◽

V. G. Nezdorovina ◽

A. A. Chuchlovin ◽

...

Keyword(s):

Surgical Treatment ◽

Adult Population ◽

Drug Resistant ◽

Treatment Optimization ◽

Unsatisfactory Result ◽

Open Research ◽

High Prevalence ◽

Low Efficiency ◽

Structural Epilepsy ◽

Drug Resistant Epilepsy

The relevance of the studied problem was caused by high prevalence of drug resistant epilepsy, an increased structural epilepsy detection and extension indications for a surgical treatment.The purpose of article consisted in a research of the reasons of low efficiency of epilepsy surgical treatment in adult population with a cross-disciplinary approach position.Material and methods.The leading approach was the retrospective open research of the failure factors at 14 patiens.Results.It was revealed unsatisfactory result of epilepsy surgical treatment was caused by a complex of the reasons. The disease features have been the main reason for a failure in 100% of cases, additional reasons: irrational pharmacotherapy -in 86%, the surgical reasons — in 36% of cases.Conclusions.The unsatisfactory result of epilepsy surgical treatment was caused by a complex of the reasons. Cross-disciplinary approach to a problem, improvement of the epilepsy managment, further researches are required. Materials of article can be useful for the personified approach at surgical treatment of epilepsy.

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Surgical treatment of children with drug-resistant epilepsy involving the Rolandic area

Epileptic Disorders ◽

10.1684/epd.2021.1279 ◽

2021 ◽

Vol 23 (2) ◽

pp. 376-384

Author(s):

Shuang Wang ◽

Hongwei Zhang ◽

Chang Liu ◽

Qingzhu Liu ◽

Taoyun Ji ◽

...

Keyword(s):

Surgical Treatment ◽

Drug Resistant ◽

Drug Resistant Epilepsy

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Surgical Resection Can Be Successful in a Large Fraction of Patients With Drug-Resistant Epilepsy Associated With Multiple Cerebral Cavernous Malformations

Neurosurgery ◽

10.1227/neu.0000000000000210 ◽

2013 ◽

Vol 74 (2) ◽

pp. 147-153 ◽

Cited By ~ 8

Author(s):

Christian von der Brelie ◽

Marec von Lehe ◽

Anna Raabe ◽

Pitt Niehusmann ◽

Horst Urbach ◽

...

Keyword(s):

Surgical Treatment ◽

Epilepsy Surgery ◽

Large Fraction ◽

Cerebral Cavernous Malformations ◽

Drug Resistant ◽

Cavernous Malformations ◽

Predictive Parameters ◽

Class 1 ◽

Drug Resistant Epilepsy

Abstract BACKGROUND: Multiple cerebral cavernous malformations (mCCMs) are known as potentially epileptogenic lesions. Treatment might be multimodal. Management of patients with mCCMs and epilepsy is challenging. OBJECTIVE: To evaluate (1) algorhythmic therapeutic sequences in patients with epilepsy associated to mCCMs, (2) whether there are predictive parameters to anticipate the development of drug-resistant epilepsy, and (3) seizure after epilepsy surgery compared to conservatively-treated drug-resistant patients. METHODS: All inpatients and outpatients with epilepsy associated to mCCMs from 1990 to 2010 and follow-up >12 months available were retrospectively analyzed. RESULTS: Twenty-three patients matched inclusion criteria. Epilepsy became drug-resistant in 18/23 (78%) patients. No predictors were found for development of drug-resistant epilepsy. Median follow-up for both groups was 7.8 years. Nine patients did not qualify for surgical therapy and were treated conservatively. One patient of this cohort (11%) was seizure-free (International League Against Epilepsy [ILAE] class 1). Surgical treatment was performed in 9 patients; 7/9 (78%) of these patients were seizure-free (ILAE class 1) after epilepsy surgery for at least 12 months compared with 1/9 patients in the non-operated group. In 7/9 cases (78%) the largest CCM was resected. In 8/9 (89%) not all CCMs were resected. CONCLUSION: After initial diagnosis of epilepsy associated to mCCMs, a primary conservative approach is reasonable. Surgical treatment can be successful in a large fraction of cases with drug-resistant epilepsy where an epileptogenic lesion is identified. Cases where surgery is not undertaken are likely to remain intractable.

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