[Impact of experience on improving the surgical outcome in temporal lobe epilepsy].

Autor:	Pastor J; Servicio de Neurofisiología Clínica, Hospital Universitario de la Princesa, Madrid, Spain. jpastor.hlpr@salud.madrid.org, Hernando-Requejo V, Domínguez-Gadea L, de Llano I, Meilán-Paz ML, Martínez-Chacón JL, Sola RG
Jazyk:	Spanish; Castilian
Zdroj:	Revista de neurologia [Rev Neurol] 2005 Dec 16-31; Vol. 41 (12), pp. 709-16.
Abstrakt:	Introduction: Recently, we have published the results of a first surgical series of patients with temporal lobe epilepsy (TLE). We describe a posterior series of patients intervened of TLE, we compare the functional results with the previous series and we finally analyze the causes of changes. Patients and Methods: We studied the first 22 consecutive patients surgically intervened of TLE with a minimum post-surgery follow-up of 2 years. Patients showing I and II Engel's grade were used as gold standard for evaluation of pre-surgical complementary studies. Results: We have obtained better functional results: 91% patients showing Engel's grade I, 9% showing grade II and neither III nor IV grades were obtained. Pre-surgical studies changed in comparison with the previous report. The most improving change was observed in video-EEG with foramen-ovale electrodes (FOE) (37%), scalp EEG (26.6%), interictal SPECT (11.7%) and MRI (11.7%). Video-EEG with FOE was the study than showed greater concordance with epileptic focus (95.5%), followed by EEG (86.4%). In 35% of cases, MRI was normal or without valid data for correct localization of focus. Conclusions: Video-EEG with FOE and TLE surgery are safety methods, which results improve with the experience. Normal or not informative MRI do not should a priori reject those patients with drug-resistant TLE from surgery.
Databáze:	MEDLINE
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