EEG lateralization and seizure outcome following peri-insular hemispherotomy for pediatric hemispheric epilepsy.

Details

Serval ID
serval:BIB_56349E5E48AA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
EEG lateralization and seizure outcome following peri-insular hemispherotomy for pediatric hemispheric epilepsy.
Journal
Child's nervous system
Author(s)
Abraham A.P., Thomas M.M., Mathew V., Muthusamy K., Yoganathan S., Jonathan G.E., Prabhu K., Daniel R.T., Chacko A.G.
ISSN
1433-0350 (Electronic)
ISSN-L
0256-7040
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
35
Number
7
Pages
1189-1195
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To determine whether preoperative non-lateralizing scalp electroencephalography (EEG) influences seizure outcome following peri-insular hemispherotomy (PIH) in pediatric hemispheric epilepsy.
Retrospective data was collected on all 45 pediatric patients who underwent PIH between 2005 and 2016. All underwent a basic pre-surgical evaluation consisting of detailed history and examination, neuropsychological assessment, MRI, and EEG. SPECT/PET, fRMI, or Wada testing were done in only eight patients. Seizure outcome was assessed using the Engel classification.
Among those who underwent hemispherotomy, 20 (44%) were females. Mean age at surgery was 8 ± 4.3 years and mean duration of symptoms was 5.2 ± 3.7 years. The most common etiologies of hemispheric epilepsy were hemiconvulsion-hemiplegia epilepsy syndrome, Rasmussen encephalitis, and post-encephalitic sequelae, together comprising 27 (60%) patients. Among the 44 patients with follow-up data (mean duration 48 ± 33 months), seizure freedom (Engel class I) was attained by 41 (93.2%). Anti-epileptic medications were stopped or decreased in 36 (82%). Seventeen (38.6%) patients had non-lateralizing EEG. Seizure outcome was not related to lateralization of EEG activity.
PIH provides excellent long-term seizure control in patients despite the presence of non-lateralizing epileptiform activity, although occurrence of acute postoperative seizures may be higher. Routine SPECT/PET may not be required in patients with a non-lateralizing EEG if there is good clinico-radiological concordance.
Keywords
EEG, Epilepsy surgery, Hemispherotomy, Peri-insular, Seizure outcome
Pubmed
Web of science
Create date
25/03/2019 8:58
Last modification date
21/08/2019 5:36
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