| Surgical management and seizure outcome in patients with tuberous sclerosis. | |
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MedLine Citation:
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PMID: 9285604 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The authors report the results obtained in 11 patients with tuberous sclerosis (TS) who underwent cortical resection surgery for medically intractable epilepsy. Patients' ages at time of surgery ranged from 3 to 46 years (mean 19.6 years). Preoperative epileptiform electroencephalographic abnormalities were focal spike wave discharges in six patients (55%), multifocal in four patients (36%), and generalized in one patient (9%). In the multifocal and generalized groups, all patients (45%) were evaluated by means of subdural grid and strip electrode recordings, whereas electrophysiological localization in the remaining patients was derived from ictal and interictal scalp recordings. The seizure foci were found to be extratemporal in six patients (55%) and temporal in five patients (45%). Surgical intervention consisted of craniotomy and seizure foci resection guided by electrocorticographic monitoring and functional mapping in five awake (45%) and six asleep (55%) patients. Neuropathological examination of the resected seizure foci revealed cortical tubers in eight patients and diffuse gliosis in three patients. Follow up ranged from 8 to 127 months (mean 35 months). Six patients (55%) were seizure free, half of whom were not receiving antiepileptic drugs (AEDs); three patients (27%) had a greater than 70% reduction in seizure frequency, although they required AEDs; one patient (9%) had a 50% temporary reduction in seizure frequency during the initial 6-month postoperative period; and one patient (9%) was lost to follow-up study. From this small but adequately followed patient population with TS, the authors conclude that cortical resection of seizure foci tailored to electrocorticographic findings and functional mapping is encouraging for this difficult to manage patient population with medically intractable epilepsy. |
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Authors:
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A M Avellino; M S Berger; R C Rostomily; C M Shaw; G A Ojemann |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of neurosurgery Volume: 87 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 1997 Sep |
Date Detail:
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Created Date: 1997-09-16 Completed Date: 1997-09-16 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 391-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurological Surgery, University of Washington School of Medicine, Seattle, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Child, Preschool Electroencephalography Epilepsy / genetics, pathology, physiopathology, surgery* Female Humans Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Tomography, X-Ray Computed Treatment Outcome Tuberous Sclerosis / complications, pathology, physiopathology, surgery* |
| Grant Support | |
ID/Acronym/Agency:
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1 R21 CA70790-01/CA/NCI NIH HHS; 1 UO1 CA62428/CA/NCI NIH HHS; T-32 NS07144/NS/NINDS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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