Lesional epilepsy surgery en adults patients
DOI:
https://doi.org/10.47924/neurotarget2013268Keywords:
lesional epilepsy, adult, tumors, mesial-temporal gliosis, cavernomas, lateral-temporal gliosis, dysplasia, displasiaAbstract
Objective: To present our 20 years of experience in surgery of lesional epilepsy in adults patients.
Population and Methods: A retrospective study based on medical records of patients with epilepsy operated on between January 1990 and December 2009 in Sanatorio Allende was perfwrmed.
Results: In this series of 25 adults patients were included: 12 tumors, 5 mesial-temporal gliosis, 5 cavernomas, 2 lateral-temporal gliosis, 1 cortical dysplasia. Localization was temporal in 12 cases (48%) and extra-temporal in 13 cases (52%). Between the moment of the evolution into epilepsy and surgery, mean was 9,88 years. There was no surgical mortality. Only one patient died 12 years after first surgery by recidive and tumoral malignization of an oligoastrocytoma.In terms of epilepsy control, surgical treatment was satisfactory. Currently, the 24 patients alive are free from disabling crises.
Conclusion: In terms of epilepsy, surgical treatment in our series was satisfactory. Of the 14 patients with refractary epilepsy: 11 have an Engel IA, 1 an Engel IB, and 2 Engel ID.
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References
Fisher RS, Van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engerl J (Jr). Epileptic Seizures and Epilepsy: Definitions Proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia 2005;46(40): 470-2.
Lardizabal DV. Medical Intractability in Epilepsy. In: Lüders HO (ed): Epilepsy Surgery. Informa. Healthcare. UK. 2008; chapter 25, pp.203-6.
Berg AT. Defining intractable epilepsy. Adv Neurol 2006;97: 5 -10.
Berg AT, Kelly MM. Defining intractability: comparisons among published definitions. Epilepsia. 2006;47(2):431-6.
Kwan P, Brodie MJ. Early identification of refractory epillepsy. N Engl J Med 2000;342:314-19.
Morris H, Najm I, Kahane P. Epilepsy Surgery: patient selection. In: Ludders HO (ed) Epilepsy Surgery Informa. Healthcare.UK. 2008; chapter 30, pp 230-7.
Carreño M, Lüders HO. General principles of presurgical evaluation. In: Lüders HO (ed) Epilepsy Surgery. Informa. Healthcare. UK. 2008; chapter 47, pp 409-22.
Spencer DD, Carpentier AC. Resection for Uncontrolled Epilepsy in the setting of Focal Lesiones on MRI: Tumor, Vascular Malformation, Trauma, and Infarction. In: Wyllie E (ed): The Treatment of Epilepsy. Lippincott Williams & Wilkins.Philadelphia. 2006; chapter: 79, pp 1087-1101.
Engel J (Jr), Van Ness PC, Rasmüssen TB, Ojeman LM. Outcome with respect to epileptic seizures. En: Engel J (Jr) (ed). Surgical Treatment of the Epilepsies. Raven Press, New York. 1993; pp. 609-21.
Campos MG, Pomata HB, Vanegas MA, Sakamoto AC. Essentials for the establishment of an epilepsy surgery program. In: Lüders HO (ed) Epilepsy Surgery. Informa. Healthcare. UK. 2008; chapter 163, pp 1537-44.
Tellez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain 2005;128:1188-98.
Engel J Jr, WiebeS, French J, Sperling M, Willianson P, Spencer et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy. Epilepsia 2003;44:741-51.
Suárez JC, Zunino S, Viano JC, Herrera E, Theaux R, Surur A, et al. Gliomas cerebrales de bajo grado en el adulto. Rev Argent Neurocir 2008;22(1):15-20.
Prayson RAPathology of Epileptogenic Neoplasms. En: Lüders HO (ed): Epilepsy Surgery. Informa Healthcar. London. 2008:1373-83.
Becker AJ, WiestlerOD, Figarella-Branger D, Blümcke I . Tumours of Neuroepitelial Tissue and Tumors of the Meninges. En: Louis DN, Ohgaki H, Wiestler OD, Cavence WK (eds): WHO Classification of Tumours of the Central Nervous System. International Agency for Research on Cancer. Lyon. WHO, 4a. edición, 2007:13-68, 95-116, 163-86.
Berger MS, Ghatan S, Haglund MM, Dobbins J, Ojeman GA. Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg 1993;79: 62-9.
Fohanno D, Bitar A. Sphenoid Ridge Meningioma. En: Advances and Technical Standards in Neurosurgery. Springer-Verlag. Wien. New York. 1986;14, pp 137-4.
Basso AJ, Carrizo A. Sphenoid Ridge Mengiomas. In: Schmidek HH (ed): Meningiomas and their Surgical Management. W.B.Saunders Company. Philadelphia. London. Toronto. Montreal. Sydney.Tokyo. 1991. Chapter: 23, pp. 233-41.
Benjamin V, McCormack B. Surgical Management of Tuberculum Sellae and Sphenoid Ridge Meningiomas. En: Schmidek HH, Sweet WH (eds): Operative Neurosurgical Techniques. W.B.Saunders Company. Philadelphia. London.Toronto. Montreal. Sydney. Tokyo. 3a. edición. 1995; Chapter 34, pp. 403-13.
Loddemkeper T, Morris HH, Dichl B, Lachhwani DK. Intracranial Lipomas and Epilepsy. J Neurol 2006; 253(5):590-3.
Tubbs RS, Louis Jr RG, Loukas M, Shoja MM, Blount JP. Giant Intracranial Lipoma. Folia Neuropathol 2007;45(4):247-9.
Fertig EJ, Spencer SS. Hippocampal Sclerosis and Dual Pathology. En: Wyllie E (ed): The Treatment of Epilepsy. Lippincott Williams & Wilkins. Philadelphia. Fourth Edition, 2006:1069-85.
Spencer SS. When should temporal-lobe epilepsy be treated surgically?. Lancet Neurol 2002;1: 375-82.
Babb T, Brown W. Pathological finding in epilepsy. En: Engel JJr (ed): Surgical Treatment of the Epilepsies. Raven Press. New York. 1987: 511-40.
Saltik S, Angay A, Ozkara C, Demirbilek V, Dervent A. A retrospec- tive analysis of patients with febrile seizure followed by epilepsy. Seizure 2003;12:211-16.
Kuzniecky RI, Jackson GD (eds): Magnetic Resonance in Epilepsy. Raven Press. New York. 1995; chapter: 5, pp.107-82.
Arruda E, Cendes F, Andermann F, Dubeau F, Villemure G, Jones-Gotman M et al. Mesial atrophy and outcome after amygdalohippocampectomy or temporal lobe remove. Ann Neurol 1996;40:446-50.
Levesque ME, Nakasato N, Vinters HV, Babb TL. Surgical treatment of limbic epilepsy associated with extrahippocampal lesion: the problem of dual pathology. J Neurosurg 1991;75:364-70.
Li LM, Cendes F, Andermann F, Watson C, Fish DR, Cook MJ et al. Surgical outcome in patients with epilepsy and dual pathology. Brain 1999;122(Pt5):799-805.-
Pomata HB, Bartuluchi M, Cuello M, Vázquez C, Petre C, Libienicki F. Epilepsia refractaria del lóbulo temporal secundaria a patologia dual. Nuestra experiencia de 32 casos. Rev Argent Neurocir 2008; 22(2):128-30.
Suárez JC, Bulacio JC, Sfaello ZM, Viano JC, Herrera EJ, Suárez MS: Epilepsia temporal refractaria por patología dual. A propósito de un caso. Rev Arg Neurocir 2008; 22(2):81-6.
Awad IA, Robinson JR. Cavernous malformations and epilepsy. En: Awad IA, Barrow DL (eds): Cavernous Malformations. AANS. Publications Committee. Park Ridge, Illinois. 1993: 49-63.
Blümcke I, Hildebrant M. Pathology of neurocutaneous abnormalities, vascular abnormalities, , post-infectious and post-traumatic pathologies associated with epilepsy. En: Lüders HO (ed): Epilepsy Surgery. Informa Healthcar. London. 2008: Chapter 144, pp. 1359-72.
Thom M, Sisodiya S. Pathology of neocortical epilepsy. En: Lüders HO (ed): Epilepsy Surgery. Informa Healthcar. London. 2008: Chapter 142; pp 1338-48.
Rogawski MA. Astrocytes get in the act in epilepsy. Nat Med 2005;11(9):919-20.
Spreafico R, Becker AJ. Pathology of malformations of cortical development. En Lüders HO ed Epilepsy Surgery. Informa Healthcare. London. 2008: 1349-58.
Loddemkeper T, Morris HH, Dichl B, Lachhwani DK. Intracranial Lipomas and Epilepsy. J Neurol 2006;253(5):590-3.
Tubbs RS, Louis Jr RG, Loukas M, Shoja MM, Blount JP. Giant Intracranial Lipoma. Folia Neuropathol 2007;45(4):247-9.
Fertig EJ, Spencer SS. Hippocampal Sclerosis and Dual Pathology. En: Wyllie E (ed): The Treatment of Epilepsy. Lippincott Williams & Wilkins. Philadelphia. 4a. edicion, 2006: 1069-85.
Suárez JC, Palacios C, Herrera EJ, Pueyrredon FJ, Surur A, Theaux R et al. Cirugía de la epilepsia lesional en niños y ado- lescentes. Rev Argent de Neurocir 2012;26(3):119-24.
Palmini A, Gambardella A, Andermann F, Dubeau F, Da Costa JC, Olivier A et al. Operative strategies for patients with cortical dysplastic lesions and intractable epilepsy. Epilepsia 1994;35 suppl 6: S57-S71.
Russo G, Tassi L, Cossu M, Cardinale F, Mai R, Castaña L et al. Focal cortical resection in malformations of cortical development-Epileptic Disord 2003;5(Suppl 2):S115-S123.
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Copyright (c) 2013 Julio César Suárez, Claudio Palacios, Enrique J. Herrera, Flavia Nieto, Francisco J. Pueryrredon, Alberto Surur, Ricardo Theaux, María S. Suárez, Juan M. Ryan, Juan C. Viano
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