Bender del BJE, Morales CL, García M, García NME

Language: Spanish
References: 25
Page: 112-119
PDF size: 133.09 Kb.

ABSTRACT

Epilepsy affects 1-2% of population and 20% of patients are cronic medically untreatable. 5-10% are candidates to epilepsy surgery with favorable results in life quality and reduction of crisis. Epilepsy Surgery Project started at CIREN in phase I with temporal lobe epilepsy. Objective: To implement the management of patient during presurgical evaluation and to standardize the clinical attention after surgical treatment with outcome. Material and Method: It is a prospective and monocenter clinical study. We evaluated patients with refractory epilepsy in a clinic during presurgical evaluation. Necessary investigations were performed in order to specify the refractory aetiology. The patients were admitted at Telemetry Unit for video EEG search. Our staff decided the surgical criterion. Adjusted temporal lobectomy and transsurgical electrocorticographic were performed. Patients had periodic postsurgical evaluation. Results: 15 patients were operated. The majority are between 20-49 years. There wasn’t any difference related to sex. Fever convulsion was the most important antecedent. Many patients with 10 years or more were found. The majority had complex partial crisis with generalization. Complications and anatomopathology are described. Postsurgical evolution showed 73% of patient’s crisis free. Conclusions: Temporal lobectomy is a technique that reduces crisis frequency in refractory epilepsy.

REFERENCES

1. Maroun F, Fitzgerald W, Rassmussen T, Jacob JC, Sadler M, Murray G, et al. Historical vignette: cerebral cortical stimulation and surgery for epilepsy. The Canadian J Neurologic Sciences 1996; 23(4).

2. Engel J. Surgery for seizures. New England J Med 1996; 334(10).

3. Hauser WA, Hesdorffer DC. Epilepsy: frecuency, causes and consequences. New York: Demos Press; 1990, p. 21-8.

4. Epilepsy surgery. In: Clinical epilepsy. Chapter 10. Duncan, Shorvon, Fish (eds.). Ed. Churchill Livingstone; 1995, p. 349-70.

5. Martín R, Díaz-Marín C, Nuévalos C, Matias-Guiu J. Factores etiológicos y pronósticos de la epilepsia tardía. Rev Neurol 1995; 23: 285-9.

6. Yañez-Lermanda A. Cirugía de epilepsia. Actualización y conceptos básicos. Es factible en países en desarrollo? Rev Neur Arg 1994; 19(4).

7. Hauser W. The natural history of temporal lobe epilepsy. In: Luders H (ed.). Epilepsy surgery. New York: Raven Press; 1991, p. 133-41.

8. Ryvlin P, Montavont A, Kahane P. The impact of epilepsy surgery on mortality: Epileptic Disord 2005; Suppl 1: 39-46.

9. Ravish VP, Gary WM. Surgical treatment of therapy-resistant epilepsy. Continuum 2004; 10(4): 100-18.

10. Carod-Artal FJ, Vásquez-Cabrera CB. Paleopatología neurológica en las culturas precolombinas de la costa y el altiplano andino (II). Historia de las trepanaciones craneales. Rev Neurol 2004; 38(9): 886-94.

11. Gowers WR. Epilepsy and other chronic convulsive diseases: their causes, syptoms and treatment. London: Churchill; 1881.

12. Wolf P. History of epilepsy surgery: introduction. In: Epilepsy surgery. Luders HO, Comair YG (eds.). Chapter 1. 2nd Ed. Ed. Lippincott Williams&Wilkins; 2001, p. 19-21.

13. Horsley V. Brain-surgery. Br Med J 1886; 2: 670-4.

14. Bourgeois BFD. Establishment of pharmacorresistancy. In: Epileptic seizures and syndromes. Wolf P (ed.). Chapter 58. England: Ed. J Libbey and Company; 1994, p. 591-8.

15. Reynolds EH. Mechanism of intractability. In: Epileptic seizures and syndromes. Wolf P (ed.). Chapter 59. England: Ed. J Lippey Company; 1994, p. 599-604.

16. Wieser HG, Engel J, Williamson PD, Babb TL, Gloor P. Surgically remediable temporal lobe syndromes. In: Surgical treatment of the epilepsies. Engel J (ed.). Chapter 5. Ed. Raven Press Ltd; 1993, p. 49-61.

17. Najm IM, Babb TL, Mohamed A, et al. Mesial temporal lobe sclerosis. In: Epilepsy surgery. Luders HO, Comair YG (eds.). 2nd ed. Ed. Lippincott Williams&Wilkins; 2001, p. 95-103.

18. Kim R, Spencer D. Surgery for mesial temporal sclerosis. In: Epilepsy surgery. Luders HO, Comair YG (eds.). 2nd Ed. Ed. Lippincott Williams&Wilkins; 2001, p. 643-51.

19. Pilcher WH, Robersts DW, Flanigin HF, Crandall PH, Wieser HG, Ojemann GA. Complications of epilepsy surgery. In: Surgical treatment of the epilepsies. Engel J (ed.). Chapter 48. Ed. Raven Press Ltd; 1993, p. 565-81.

20. Oxbury JM. Surgical treatment of epilepsy. In: Principles and practice of restorative neurology. Young RR, Delwaide PJ (ed.). BH Ltd; 1992.

21. Lüders HO. Protocols and outcome statistics from Epilepsy surgery centres. In: Epilepsy surgery. Luders HO, Comair YG (eds.). 2nd Ed. Ed. Lippincott Williams&Wilkins; 2001, p. 973-8.

22. Sindou M, Guenot M, Isnard J, et al. Temporo-mesial epilepsy surgery: outcome and complications in 100 consecutive adult patients. Acta Neurochir(Wien) 2005.

23. Babb TL. Pathology of the temporal lobe: hippocampal sclerosis. In: Epilepsy surgery. Luders HO, Comair YG (eds.). 2nd. Ed. Ed Lippincott Williams&Wilkins; 2001, p. 901-6.

24. Spencer SS, Berg AT, Vickrey BG, et al. Predicting long-term seizure outcome after resective epilepsy surgery: the multicenter study. Neurology 2005; 65(6): 912-8.

25. Jeong SW, Lee SK, Hong KS, et al. Prognostic factors for the surgery for mesial temporal lobe epilepsy: longitudinal analysis. Epilepsia 2005; 46(8): 1273-9.