Surgical Outcomes of Extratemporal Epilepsy
Abstract number :
2.429
Submission category :
9. Surgery / 9C. All Ages
Year :
2023
Submission ID :
1357
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Miroslava Ortiz Cuevas, MD – University of Guanajuato
Sara Patricia Perez Reyes, MD – Neurosurgery – Hospital Regional de Alta Especialidad del Bajio; Jaime Ivan Castro Macias, MD – Neurophysiology – Hospital Regional de Alta Especialidad del Bajio; Ricardo Garcìa Cazarez, MD – Neurological endovascular therapy – Hospital Regional de Alta Especialidad del Bajio; Raul Garcia Diaz de Leon, Pysch – Neuropsycology – Hospital Regional de Alta Especialidad del Bajio; Alejandro Miranda Gonzalez, MD – Neurosurgery – Hospital Regional de Alta Especialidad del Bajio
Rationale:
This study aims to assess pathology associated with extratemporal epilepsy and seizure control outcomes in a reference center.
Methods:
A descriptive, retrospective, and observational study was conducted. Period was from January 1, 2011 to June 30, 2022. All patients undergoing surgical treatment for extratemporal epilepsy with a minimum follow-up of one year were included.
Results:
Forty-five patients were included. Average age at first seizure was 60 months (SD± 87), age at referral to the HRAEB was 20 years (SD± 6.8), age at surgery: 27 years (8-45). Women accounted for 79%, invasive monitoring (2/14, 14%). Average follow-up time: 36 months. Localization: frontal 54% (left 46%, right 8%), Lennox-Gastaut Syndrome (LGS) associated with multifocal epilepsy 22%, parietal 8%, insula 8%, Rasmussen Encephalitis (RE) 8%. Etiology: tumoral (9/45, 21%), cavernoma (6/45, 14%), autoimmune encephalitis (2/45, 4%), RE (1/14, 2%), arteriovenous malformation (4/45, 8%), Focal Cortical Dysplasia (FCD) (14/45 (31%), associated with LGS (9/45, 21%). Type of surgery: resection guided by electrocorticography (ECoG) 36/45 (80%), with NNV support 8/11 (73%), callosotomy 2/3 anterior 9/45 (20%). Complications: transient disconnection syndrome: 1/13 (2.2%), motor deficit (non-dense): 2/15 (4.4%), fistula: 1/13 (2.2%), hydrocephalus: 1/45 (2.2%), neuroinfection: 1/45 (2.2%). Seizure control, Engel at one-year follow-up: 1A (27/45, 60%), Engel at the follow-up time: 1A (50%), 2A (14%), 2B (14%), 3B.
Conclusions:
Extratemporal epilepsy is more frequent in younger patients. The most common site is frontal. Seizure control outcomes are lower than in temporal resections, likely due to greater extension and association with eloquent areas
Funding: Hospital Regional de Alta Especialidad del Bajio
Surgery