Surgical outcomes for medically refractory epilepsy secondary to posterior cortex ulegyria as sequelae of perinatal insults
| Autor: | Nilesh Kurwale, Nayan Wadhwani, Deepa Bapat, Aniruddha Joshi, Sandip B. Patil, Yogeshwari Deshmukh, Sujit Jagtap, Sonal Chitnis, Sujit Nilegaonkar |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Drug Resistant Epilepsy Group A Group B 03 medical and health sciences Epilepsy 0302 clinical medicine Medicine Corpus callosotomy Humans Ictal Epilepsy surgery Child Cerebral Cortex business.industry Infant Electroencephalography medicine.disease Magnetic Resonance Imaging Surgery 030104 developmental biology Treatment Outcome Neurology Child Preschool Cohort Reflex Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsy research. 175 |
| ISSN: | 1872-6844 |
| Popis: | To study surgical outcomes in pharmaco-resistant epilepsy associated with posterior cortex ulegyria secondary to perinatal insults.A cohort was analysed for clinico-radiological charectaristics, surgical interventions and seizure outcomes.A total of 38 patients underwent surgery, divided as group A - curative surgeries (n = 20) and group B - palliative surgeries (n = 18). Mean age of onset of epilepsy in group A was 5.2 ± 3.4 years against 2.7 ± 2.4 years in group B (p 0.01). Electroclinical Lennox Gastaut Syndrome was encountered in 9/20 patients in group A, against all 18 patients in group B. Disabling reflex epilepsy was seen in 10 (26 %) patients. Interictal electrophysiology localized in the posterior cortex in all patients in group A, but ictal onsets contributed in only 7/20 patients. Nine patients from group A had unilateral parieto-occipital ulegyria while bilateral in 11/20 patients, and 16/18 from group B. Group A patients underwent parieto-occipital resection (n = 10) and temporo-parieto-occipital disconnection (n = 10) while group B underwent complete corpus callosotomy (n = 18). In group A, Engel Ia outcome was achieved in 15/20 patients (75 %) at mean follow up of 23.5 ± 7.9 months. Group B patients experienced cessation of head drops in all 18 patients, with two-third reduction in seizure frequency at 29.2± 12.4 months of mean follow up. Reflex seizures responded completely in both groups.Epilepsy surgeries for posterior cortex ulegyria results in excellent seizure outcomes. Corpus callosotomy appears highly effective as a palliation for head drop as well as disabling reflex seizures in a well selected cohort. |
| Databáze: | OpenAIRE |
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