Electrocorticographic Patterns in Epilepsy Surgery and Long-Term Outcome
| Autor: | Héctor Zúñiga-Gazcón, María del Carmen Fernández-González de Aragón, Natalia Hernández-Segura, Brenda González-Pérez, Daniel San-Juan, Axel Hernandez-Ruiz, Mario Alonso-Vanegas, Esmeralda Cobos-Alfaro, Dulce Anabel Espinoza-López, Carlos Trenado |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Drug Resistant Epilepsy Pediatrics medicine.medical_specialty Time Factors Intraoperative Neurophysiological Monitoring Physiology Intraoperative Electrocorticography Kaplan-Meier Estimate Severity of Illness Index Outcome (game theory) 03 medical and health sciences Epilepsy 0302 clinical medicine Physiology (medical) Severity of illness Humans Medicine Epilepsy surgery Electrocorticography Retrospective Studies Analysis of Variance medicine.diagnostic_test business.industry Brain Retrospective cohort study Prognosis medicine.disease Logistic Models Treatment Outcome Neurology 030220 oncology & carcinogenesis Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies Intraoperative neurophysiological monitoring |
| Zdroj: | Journal of Clinical Neurophysiology. 34:520-526 |
| ISSN: | 0736-0258 |
| Popis: | The role of intraoperative electrocorticography (iECoG) and of its patterns in epilepsy surgery have shown contradictory results. Our aim was to describe iECoG patterns and their association with outcome in epilepsy surgery.We retrospectively analyzed 104 patients who underwent epilepsy surgery (2009-2015) with pre- and postresection iECoG. We described clinical findings, type of surgery, preresection iECoG patterns according to Palmini et al., 1995 (sporadic, continuous, burst, and recruiting interictal epileptiform discharges-IEDs) and postresection iECoG outcome (de novo, residual, and without IEDs). The Engel scale was used to evaluate the outcome. Descriptive statistics, Kaplan-Meier, the logistic regression model, and analysis of variance tests were used.We included 60.6% (63/104) females, with a mean age of 35 (±10.2) years at the time of epilepsy surgery. The etiologies were hippocampal sclerosis (63.5%), cavernomas (14.4%), cortical dysplasia (11.5%), and low-grade tumors (10.6%). The most common preresection iECoG pattern was sporadic IEDs (47%). Postresection iECoG patterns were de novo (55.7%), residual (27.8%), and without IEDs (16.3%). Mean follow-up was 19.2 months. Engel scale was as follows: Engel I (91 patients, 87.5%), Engel II (10 patients, 9.6%), and Engel III (three patients, 2.9%). Analysis by mixed-design analysis of variance showed a significant difference between etiology groups with a strong size effect (P = 0.021, η = 0.513) and also between preresection iECoG patterns (P = 0.008, η = 0.661).Preresection iECoG patterns and etiology influence Engel scale outcome in lesional epilepsy surgery. |
| Databáze: | OpenAIRE |
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