A Neurofunctional Evaluation Strategy for Presurgical Selection of Temporal Lobe Epilepsy Patients

被引：0

作者：

Morales Chacon, Lilia Maria ^{[1
]}

Sanchez Catasus, Carlos

Bender, Juan E. ^{[2
]}

Bosch Bayard, Jorge ^{[3
]}

Garcia, Maria E. ^{[4
]}

Garcia Maeso, Ivan

Lorigados Pedre, Lourdes ^{[5
]}

Estupinan Diaz, Barbara ^{[6
]}

Trapaga Quincoses, Otto ^{[7
]}

Baez Martin, Margarita ^{[7
]}

Sanchez Coroneaux, Abel ^{[7
]}

Perez Madrigal, Digna ^{[8
]}

Guevara, Miriam ^{[8
]}

Zaldivar Bermudez, Marilyn ^{[7
]}

Aguila, Angel

机构：

[1] Int Neurol Restorat Ctr CIREN, Brain SPECT Lab, Clin Neurophysiol Sect, Havana, Cuba

[2] Int Neurol Restorat Ctr CIREN, Adult Stat Les Clin, Havana, Cuba

[3] Cuban Neurosci Ctr CNEU RO, Havana, Cuba

[4] Int Neurol Restorat Ctr CIREN, Childrens Neurol Clin, Havana, Cuba

[5] Int Neurol Restorat Ctr CIREN, Chem Neuroimmunol Lab, Havana, Cuba

[6] Int Neurol Restorat Ctr CIREN, Dept Neuropathol, Havana, Cuba

[7] Int Neurol Restorat Ctr CIREN, Neurophysiol Serv, Havana, Cuba

[8] Int Neurol Restorat Ctr CIREN, Telemetry Unit, Havana, Cuba

来源：

MEDICC REVIEW | 2009年 / 11卷 / 01期

关键词：

Epilepsy; temporal lobe; surgery; EEG; SPECT; MRI; SPECT PERFUSION CHANGES; HIPPOCAMPAL SCLEROSIS; INTRACTABLE EPILEPSY; INTERICTAL SPECT; CONTROLLED TRIAL; EEG PATTERNS; SEIZURE; SURGERY; RECORDINGS; SCALP;

D O I：

暂无

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Introduction Temporal lobe epilepsy (TLE) is the prototype of a surgically correctable syndrome. Successful surgical outcomes depend on a thorough presurgical evaluation aimed primarily at identifying the epileptogenic zone. Objective Describe the noninvasive presurgical selection and evaluation strategy for TLE patients introduced at the International Neurological Restoration Center (CIREN) in Havana, Cuba, and evaluated between 2001 and 2006 for its accuracy in identifying candidates for non-lesional resection surgery. Methods lctal onset electrographic patterns of 1,679 seizures in 72 patients with drug-resistant partial epilepsy, obtained through long-term scalp Video EEG (V-EEG) monitoring, were evaluated. The correlation between the V-EEG-defined epileptogenic zone and the dysfunction shown by single photon emission computed tomography (ictal and interictal brain SPECT) and nuclear magnetic resonance spectroscopy (MRS) was established. Results V-EEG monitoring determined that 44.4% of evaluated patients had complex partial temporal lobe seizures. Identification of patients with medial temporal epilepsy (MTE) increased as a result of lateralization and localization of the dominant mean ictal pattern frequency (5.56 +/- 1.31 Hz) during the period of maximum spectral power VARETA localization of an ictal epileptiform activity source coincided with the epileptogenic zone in all TLE patients who subsequently underwent a successful temporal lobectomy. Semi-quantitative analysis of ictal and interictal brain SPECT images, as well as metabolic ratios measured by MRS, combined with V-EEG findings, enabled localization/lateralization of the epileptogenic zone in TLE patients whose MRIs were normal or showed bilateral structural abnormalities. Conclusions Confirmation of correct localization/lateralization of the epileptogenic zone following successful surgical outcomes in selected TLE patients led CIREN to develop a surgical treatment strategy for patients in Cuba with drug-resistant temporal lobe epilepsy. This strategy offers an appropriate, cost-effective treatment alternative for developing countries like Cuba, with the benefit of significantly improving TLE patients' quality of life.

引用

页码：29 / 35

页数：7