Document Detail

Posterior cortex epilepsy secondary to ulegyria: is it a surgically remediable syndrome?
MedLine Citation:
PMID:  18557774     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To examine whether surgery is indicated for posterior cortex epilepsy secondary to ulegyria. PATIENTS AND METHODS: Ten patients who underwent surgery for posterior cortex epilepsy with ulegyria and were followed for more than 2 years were included. All patients underwent comprehensive presurgical evaluations. Five patients underwent intracranial electroencephalography (EEG) studies. The posterior cortex including the magnetic resonance imaging (MRI) lesion was resected in all patients. Postoperative follow-up period was 2-12 (mean 6) years. RESULTS: Nine patients had a history of perinatal distress including asphyxia and prolonged labor. Age at seizure onset was 5-11 years, except one patient. Three patients had visual field defects preoperatively. Ulegyria was unilateral in four patients and bilateral but unilateral-predominant in six patients. In most of the cases, the lesions were in the posterior cerebral artery area or the watershed area between middle cerebral and posterior cerebral arteries. In four of five patients who underwent intracranial EEG, seizure onset zones extended outside the lesions. Postoperative seizure outcome was Engel's class I in seven cases, and class III in three cases. Three of four patients whose seizure onset zones were not completely resected achieved class I outcome. Four of six patients with bilateral lesions achieved class I outcome. CONCLUSION: Ulegyria due to perinatal distress is considered to be a major cause of posterior cortex epilepsy. Long-term postoperative seizure outcome is favorable. Resection of MRI lesion is important for seizure relief. Bilateral lesions should not be excluded from surgical indication. The usefulness of intracranial EEG may be limited.
Naotaka Usui; Tadahiro Mihara; Koichi Baba; Kazumi Matsuda; Takayasu Tottori; Shuichi Umeoka; Fumihiro Nakamura; Kiyohito Terada; Keiko Usui; Yushi Inoue
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-06-13
Journal Detail:
Title:  Epilepsia     Volume:  49     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-03     Completed Date:  2009-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1998-2007     Citation Subset:  IM    
National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
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MeSH Terms
Cerebral Cortex / abnormalities*,  surgery*
Electroencephalography / methods
Epilepsy / etiology,  pathology,  surgery*
Hemispherectomy / adverse effects*
Longitudinal Studies
Magnetic Resonance Imaging / methods
Retrospective Studies
Seizures / etiology,  surgery
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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