Identification and removal of an epileptogenic lesion using Ictal-EEG, functional-neuronavigation and electrocorticography
| Autor: | Ali Savas, Atilla Erdem, Ayse Karatas, İlhan Erden, Banu Yagmurlu, Erhan Bilir, Gülnihal Kutlu |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Neuronavigation Electroencephalography Neurosurgical Procedures Epilepsy Seizures Parietal Lobe Physiology (medical) medicine Humans Epilepsy surgery Electrocorticography DNET medicine.diagnostic_test business.industry Dysembryoplastic Neuroepithelial Tumor Motor Cortex General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Temporal Lobe Electrodes Implanted Surgery medicine.anatomical_structure Neurology Neurology (clinical) Radiology business Motor cortex |
| Zdroj: | Journal of Clinical Neuroscience. 11:343-346 |
| ISSN: | 0967-5868 |
| Popis: | Purpose: Cases with intractable epilepsy may present with multiple lesions in their brains. Ictal-EEG carries a great value in identification of the primary epileptogenic source. On the other hand, removal of low-grade tumors located around the eloquent cortex may be risky with conventional techniques. Functional-neuronavigation (f-NN) is the integration of functional magnetic resonance imaging and stereotactic technologies; and provides interactive data regarding localization of the motor cortex. This report presents a case with dysembryoplastic neuroepithelial tumor (DNET), which was removed using f-NN and electrocorticography (ECoG) techniques. Methods: A 19-year-old patient with intractable complex partial and secondary generalized seizures is presented. MRI revealed a low-grade tumor located in right parietal region just behind the motor cortex, and a contralateral temporal arachnoid cyst. Ictal-EEG demonstrated the right parietal origin of the seizures. The patient underwent a right parietal craniotomy and tumor excision using f-NN and ECoG techniques intraoperatively. ECoG findings correlated with epileptogenicity of the parietal lesion. Results: Postoperative course was uneventful. No postoperative deficit was observed. The patient was seizure free in eight months follow-up. Pathological examination reported the lesion as DNET. Conclusions: Ictal-EEG has a very important role in identification of the epileptogenic focus in cases with multiple brain lesions. Preservation of the functional cortex is the most prominent aim during lesional surgery of epilepsy. Intraoperative mapping using f-NN and ECoG supports the orientation of the neuro surgeon to the functional and epileptogenic cortical areas; and thus, increase the safety and efficacy of surgical procedures. (C) 2003 Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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