Abstracts

Foci localization by different techniques may overlap only partially. We compared the concordance between interictal EEG, MR imaging, interictal SPECT, ictal video EEG and histopathology of the surgically resected brain tissue in the localization of epileptic foci in patients operated for intractable epilepsy at All India Institute of Medical Sciences (AIIMS), New Delhi.We studied the outcome data at 1 year followup and coreelated this with the concordance of the various modes of investigations done presugrgically. This prospective tudy which included 187 consecutive patients of intractable epilepsy undergoing presurgical evaluation for epilepsy surgery admitted for long term video EEG epilepsy in the neurology wards from april 1995 till dec 03. The concordance rates for interictal EEG, interictal SPECT, MRI and ictal video EEG (VEEG) were calculated and compared with pathological diagnosis outcome data was also seen. The mean age was 19.6 yr+11.6(range 4 months-59yr). Histopathology (HP) was concordant with ictal video EEG, interictal EEG, MRI and SPECT in 66.6%, 43.85%, 86.76%, and 66.6% respectively. Ictal video EEG was concordant with interictal EEG, MRI and interictal SPECT in 66%, 72% [amp] 74% of cases respectively. MRI was concordant with interictal EEG and SPECT in 52% and 90% of cases while SPECT was concordant with routine EEG in 46% of cases.The outcome GOOD (Group I and II Engel scoring was seen in 92% of DNET, 75% of MTS, 32% in CD).The seizure outcome was also good in patients who underwent a hemispherotomy.Quality of life outcome were also done , pre and post surgical neuropsychological evaluation by the All India Institute Of Medical Sciences Neurosychological battery (standardised to our population modified Luria Nebraska) was done. The best outcome was seen in DNET , followed by Mesial temporal sclerosis and the worst in Cortical dysplasia.There is a definite improvement in qualty of life and memory function after surgical treatment of intractable epilepsies done with minimum modalities of EEG, VEEG, MRI, SPECT (Ictal and Interictal) in a developing country like India.