gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Predictive value of electrocorticography in epilepsy patients with unilateral hippocampal sclerosis undergoing selective amygdalohippocampectomy

Prädiktiver Wert der Elektroenzephalographie bei Patienten mit einseitiger hippocampaler Sklerose bei selektiver Amygdalohippokampektomie

Meeting Abstract

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  • X. Chen - Klinik für Neurologie, Philipps-Universität, Marburg
  • U. Sure - Klinik für Neurochirurgie, Philipps-Universität, Marburg
  • A. Haag - Klinik für Neurologie, Philipps-Universität, Marburg
  • S. Knake - Klinik für Neurologie, Philipps-Universität, Marburg
  • B. Fritsch - Klinik für Neurologie, Philipps-Universität, Marburg
  • H. H. Müller - Institut für Med. Biometrie und Epidemiologie, Interdisziplinäres Epilepsiezentrum, Philipps-Universität, Marburg
  • R. Becker - Klinik für Neurochirurgie, Philipps-Universität, Marburg
  • W. H. Oertel - Klinik für Neurologie, Philipps-Universität, Marburg
  • H. Bertalanffy - Klinik für Neurochirurgie, Philipps-Universität, Marburg
  • H. M. Hamer - Klinik für Neurologie, Philipps-Universität, Marburg
  • corresponding author F. Rosenow - Klinik für Neurologie, Philipps-Universität, Marburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP013

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0281.shtml

Published: May 4, 2005

© 2005 Chen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To evaluate the predictive value of intraoperative electrocorticography (ECoG) in patients with unilateral hippocampal sclerosis (HS) undergoing transsylvian selective amygdalohippocampectomy (sAHE).

Methods

ECoG was recorded before and after resection in 22 patients with medically resistant mesial temporal lobe epilepsy. The sAHE was performed, regardless of ECoG findings. ECoG findings recorded from the mesiobasal temporal lobe (MTL) and lateral temporal lobe (LTL) before and after the sAHE were correlated with seizure outcome 12 months later (group 1: completely seizure free, group 2: not completely seizure free).

Results

Ten patients had right sided and 12 left sided HS. Average age was 37.1 years. Pre-resection spikes were restricted to the MTL in 11 patients (50%) and to the LTL in one (4.5%). In three patients (13.6%) spikes were recorded from MTL and LTL and in seven (31.8%) no spikes were recorded before the resection. Fifteen patients (68%) remained completely seizure free and 19 (86%) were in Engel’s class I postoperatively. Patients with preresection spikes restricted to the MTL (n=11) remained seizure free more frequently (9/11, 82%) as compared to other patients (6/11, 55%; p=0.36). Two of four patients with LTLspikes and four of seven patients without preresection spikes remained seizure free. The frequency of preresection spikes and the persistence of preresection spikes in the postresection ECoG were not significantly related to the seizure outcome.

Conclusions

Pre-resection ECoG may be helpful in the prediction of seizure outcome in patients undergoing sAHE for mesial temporal lobe epilepsy. Especially patients with preresection spikes restricted to the MTL seem to have a favourable postresectional outcome. Based on the differences found in this pilot study, calculations indicated that a study including more than 100 patients is needed to determine the predictive value of ECoG in patients with mesial temporal lobe epilepsy.