ELECTROCORTICOGRAPHY IMPROVES EPILEPSY SURGERY OUTCOMES: REULTS OF 183 PATIENTS FROM MILWAUKEE
Abstract number :
1.316
Submission category :
Year :
2002
Submission ID :
3381
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
George L. Morris, Francesca Galli, Ilana Ruff, Wade M. Mueller, Lalitha Gunamraj. Regional Epilepsy Center, St Luke[ssquote]s Medical Center, Milwaukee, WI; Department of Neurology, University of Florence, Florence, Italy; Department of Neurosurgery, MCW,
RATIONALE: Determine the influence of electrocorticography (ECoG) on the post-operative seizure status of surgically-treated medically-resistant epilepsy patients. Recording the electroencephalogram from the cortical surface or electrocorticography may assist in a more efficacious outcome to epilepsy surgery. Abnormal results and the type of abnormalities may have a role in modifying the surgery. We reviewed the seizure outcome results of patients without and with ECoG and the nature of the abnormalities to determine if ECoG influences surgical outcome.
METHODS: A retrospective review of all patients with a surgical treatment of epilepsy by the Comprehensive Epilepsy Program in Milwaukee, WI was made for the presence of ECoG at the time of surgery and the nature of the results. This information was added to a prospective database of surgical patient evaluation and outcome. Analysis was performed on the presence of ECoG and it[ssquote]s findings and the subsequent seizure status outcome. Pearson Chi-Square values were generated for the comparisons.
RESULTS: The database produced 183 epilepsy surgery patients with 6 month seizure outcome information. ECoG was performed on 90. The performance of ECoG or the presence of an abnormality had no influence on seizure outcome (60% with ECoG and 75% without seizure free, p=0114 and 78 of 90 abnormal ECoGs, p=0.452) Epilepsy surgery was performed in the temporal lobe in 164. Complete information was present in 133 patients. ECoG was not performed in 59 and was done in 74. A significantly better outcome was seen with ECoG (85% with vs. 61% without ECoG seizure free, p=0.006). ECoG was abnormal in 89% without significant differences in seizure outcome. Epileptiform abnormalities were present in 65 of 66 abnormal ECoG studies. The location of these abnormalities also had no significant influence on seizure outcome.
CONCLUSIONS: ECoG influences the outcome of Epilepsy surgery at our center but only in temporal lobectomy and not dependently on the presence of an abnormality. Patient numbers are seemingly large enough to find effects but due to few non-seizure-free outcomes some groups were small. Further analysis of patient evaluation features may help indicate the group best assisted by ECoG.