54. Long term surgical results in supplementary motor area epilepsy surgery

Autor: Paul Shkurovick Bialik, Erika Brust Mascher, Ricardo M. Buentello Garcia, Daniel San-Juan, Mario Alonso-Vanegas, Carlos Trenado, Carlos Castillo-Montoya, Horacio Senties-Madrid
Rok vydání: 2016
Předmět:
Zdroj: Clinical Neurophysiology. 127:e315
ISSN: 1388-2457
Popis: Objective To show surgical results in SMA epilepsy patients in two reference centers in Mexico City. Material and methods Retrospective study (1999–2014), of 52 patients submitted to lesionectomy and/or corticectomy of the SMA guided by electrocorticography (ECoG). We describe the clinical, neurophysiological, neuroimaging and pathological findings. The Engel scale was used to classify surgical outcome. Descriptive statistics, t Student, Friedman, Kruskal Wallis and Chi-square tests were used. Results 52 patients, mean age at epilepsy onset 26.3 years, mean preoperative monthly seizure frequency 14. Etiology: 28 (53.8%) low-grade tumors, 17 (32.7%) cortical dysplasia and 7 (13.5%) cavernomas. At a mean follow-up of 5.7 (1–10) years, 32 patients (61%) were Engel I, 16 (31%) Engel II and 4 (8%) Engel III. Overall seizure reduction was significant (p = 0.001). The absence of post-surgical early seizures, and lesional etiology were related with Engel I (p = 0.05). Twenty-six (50%) patients had complications in postoperative period all of which resolved completely. Conclusions Surgery of SMA epilepsy guided by ECoG, using a multidisciplinary and multimodality approach is a safe and feasible procedure showing good seizure control, moderate morbidity and no mortality. Significance Surgery of SMA epilepsy guided by ECoG is effective (61%, Engel I) and safe to long term.
Databáze: OpenAIRE
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