SEEG-guided thermocoagulations: a palliative treatment of nonoperable partial epilepsies

Details

Serval ID
serval:BIB_B70049355A5E
Type
Article: article from journal or magazin.
Collection
Publications
Title
SEEG-guided thermocoagulations: a palliative treatment of nonoperable partial epilepsies
Journal
Neurology
Author(s)
Catenoix H., Mauguiere F., Guenot M., Ryvlin P., Bissery A., Sindou M., Isnard J.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
2008
Volume
71
Number
21
Pages
1719-26
Language
english
Notes
Catenoix, H
Mauguiere, F
Guenot, M
Ryvlin, P
Bissery, A
Sindou, M
Isnard, J
eng
Neurology. 2008 Nov 18;71(21):1719-26. doi: 10.1212/01.wnl.0000335166.20451.88.
Abstract
OBJECTIVE: Intracranial stereotactic EEG recordings (SEEG) in presurgical epilepsy assessment are currently carried out in our department. The SEEG method generally used for exploration can also be used to perform radiofrequency thermocoagulations (RFTC) of the epileptic foci. To assess the indications of the RFTC procedure in the therapeutic arsenal of drug-resistant epilepsies, we report the results obtained in 41 patients to whom RFTC was proposed as a first therapeutic step before surgery or as a palliative treatment when surgery was not possible. METHODS: RFTC were produced by applying a 50-volt, 110 mA current, during 10-30 seconds within the epileptogenic zone, as identified by the SEEG investigation. Two to 31 RFTC (mean, 12) were performed per patient. The median follow-up was 19 months (range: 4 to 72). RESULTS: Twenty patients (48.7%) experienced a seizure frequency decrease of at least 50%, which was over 80% in eight of them. One patient was seizure-free. The tolerance was excellent. A total of 67% of the 21 patients presenting a cortical development malformation benefited from RFTC (p = 0.052). In the group of noneligible patients for resective surgery (n = 13), six were responders to SEEG-guided RFTC and one of them was seizure-free. CONCLUSIONS: This study suggests that stereotactic EEG-guided radiofrequency thermocoagulations can be proposed only as a palliative procedure, able to bring a substantial improvement of seizure frequency, to drug-resistant patients with epilepsy for whom conventional resection surgery is risky or contraindicated on the basis of invasive presurgical evaluation.
Keywords
Adolescent, Adult, Anticonvulsants/therapeutic use, Child, Combined Modality Therapy, Electroencephalography/*methods, Epilepsies, Partial/pathology/*therapy, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/methods, Male, Middle Aged, Palliative Care/*methods, Positron-Emission Tomography/methods, Radiosurgery/*methods, Statistics, Nonparametric, Stereotaxic Techniques, Tomography, Emission-Computed, Single-Photon/methods, Treatment Outcome, Young Adult
Pubmed
Create date
29/11/2018 12:36
Last modification date
20/08/2019 15:25
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