Intraoperative Electrocorticographic patterns in epilepsy surgery and long-term outcome.
Abstract number :
2.375
Submission category :
9. Surgery / 9A. Adult
Year :
2016
Submission ID :
226240
Source :
www.aesnet.org
Presentation date :
12/4/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Edith natalia N. Hernandez segura, INSTITUTO NACIONAL DE NEUROLOGIA Y NEUROCIRUGIA, Mexico; Daniel San-Juan, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; and Mario A. Alonso vanegas, INSTITUTO NACIONAL DE NEUROLOGIA Y NEUROCIRUGI
Rationale: The intraoperative electrocorticographic (iECoG) patterns and their association with the long-term outcome in epilepsy surgery are controversial. Methods: We retrospectively analyzed 104 patients who underwent epilepsy surgery (September 2009-January 2015) with pre- and post-resection iECoG. We described; clinical findings, etiology, type of surgery, resected lobe, pre-resection iECoG patterns according to Palmini et al. 1995 (sporadic, continuous, burst and recruiting interictal epileptiform discharge [IEDs]) and post-resection iECoG outcome (de novo, residual and without IEDs). Engel scale was used to classify the epilepsy outcome with a follow-up of 6, 12, 18, 24 and 60 months. Descriptive statistics, Kapplan Meier and ANOVA tests were conducted. Results: We included 60.6% (63/104) females and 39.4% (41/104) males, mean age of 35 (10.2) years at time of epilepsy surgery. The etiologies were; hipocampal sclerosis 63.5%, cavernomas 14.4%, cortical dysplasia 11.5% and low grade tumors 10.6%. Resected lobes were; temporal 89.4%, frontal 7.7% and parietal 2.9%. Types of surgery were amygdalo-hippocampectomy plus anterior temporal lobectomy 65% or lesionectomy 35%. The most common pre-resective iECoG pattern was the sporadic IEDs (47%), followed by sporadic/recruiting (41%). Post-resective iECoG patterns were: de novo (55.7%), residual (27.8%) and without IEDs (16.3%). The mean follow was 34.6 (6-79) months. Engel scale was Engel I 91 (87.5%), Engel II 10 (9.6%) and Engel III 3 (2.9%). In the mixed design ANOVA test only the etiology (n2: 0.513), sex (n2: 0.003) and pre-resective iECoG patterns (n2: 0.661) were related significant with strong effect size in the Engel scale. Kaplan Meier curve showed a trend between the seizure free versus seizure no-free patients and post-resective iECoG outcome (X2=0.067). Conclusions: Pre-resective iECoG patterns, etiology and sex were related with Engel scale outcome in patients who underwent epilepsy surgery due to several etiologies. Funding: Without funding
Surgery