medigraphic.com

2019, Number S1

<< Back Next >>

Cuba y Salud 2019; 14 (S1)

Extratemporal epilepsy. Neuropathological diagnosis and post-surgical clinical evolution. National Epilepsy Surgery Program, 2002-2017

Estupiñan DBO, Morales CLM, Lorigados PL, Báez MMM, Quintanal CN, Fernández JI, Solomón CMT, González GJ, Bender BJE, de Arriba RM, Gómez SHJ, Salinas OMR, Ríos CMC, Santos SA, Hernández DZM, Morales MME, Charles BD

Language: Spanish
References: 18
Page: 33-37
PDF size: 608.36 Kb.


ABSTRACT

In centers dedicated to epilepsy surgery, about 20% of surgical interventions involve extratemporal epilepsy and the majority of cases correspond to the frontal lobe. The objective was to evaluate the neuropathological findings and the post-surgical clinical evolution in patients with drug-resistant extratemporal epilepsy treated in the National Epilepsy Surgery Program. From the database (Pathological Anatomy) of patients with drugresistant focal epilepsy, operated between 2002 and 2017, cases with extratemporal epilepsy were selected. All surgeries were guided by electrocorticography. Of the 64 patients studied, 17 were extratemporal. The average age at the time of surgery was 24.7 years In 66.66%, lesions were detected in imaging studies. Histological diagnoses were focal cortical dysplasia type I (4), IIa (1) and IIb (5); pilocytic astrocytoma (1); cavernous angioma (1); ganglioglioma (1); meningioangliomatosis (1); polymicrogyria (1) and descriptive (2). In the last evaluation, 8 patients continued with epileptic seizures (47.05%), 6 were without seizures (35.29%) and 3 did not attend the consultation. 26.56% of the patients corresponded with extra-temporal epilepsy, a result similar to that described in the literature. Neuropathological diagnoses are similar to those found in temporal lobe epilepsy with a predominant focal cortical dysplasia. Although the post-surgical outcome is inferior to temporary resections, surgery offers a benefit to these patients by reducing the frequency of seizures.


REFERENCES

  1. Jobst BC, Cascino GD. Resective epilepsy surgery for drug resistant epilepsy.JAMA. 2015;313:285-93.

  2. Kutsy RL. Focal extratemporal epilepsy: clinical features, EEG patterns, and surgical approach. J Neurol Sci. 1999;166:1-15.

  3. Harvey A, Cross JH, ShinnarS, MathernGW, Taskforce IPESS.Defining the spectrum of international practice in pediatric epilepsy surgery patients.Epilepsia. 2008;49:146-55.

  4. Jeha LE, Najm I, Bingaman W, Dinner D, Widdess-Walsh P, Luders H. Surgical outcome and prognostic factors of frontal lobe epilepsy surgery. Brain. 2007;130:574-84.

  5. Tellez Zenteno JF, Wiebe S, López-Méndez Y. Epilepsia extratemporal. Aspectos clínicos, diagnósticos y de tratamiento. RevNeurol. 2010;51 (2): 85-94.

  6. Morales Chacón LM. Parte I: Lineamientos de la cirugía: Lineamientos del Capítulo Cubano de la Liga Internacional Contra la Epilepsia. En: Morales Chacón LM, ed. Epilepsias farmacorresistente: su tratamiento en Cuba. La Habana: Ciencias Médicas; 2017. pp. 1-8.

  7. Bender del Busto JE; González González, J. Parte I: Lineamientos de la cirugía: Evaluación clínica pre y postquirúgica. En: Morales Chacón LM, ed. Epilepsias farmacorresistente: su tratamiento en Cuba. La Habana: Ciencias Médicas; 2017. pp. 9-20.

  8. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO classifications of tumours of the Central Nervous System. 4th ed. Lyon: IARC; 2007.

  9. Blümcke I, Thom M, Aronica E, Armstrong DD, Vinters HV, Palmini A, et al. The clinicopathologic spectrum of focal cortical dysplasias: A consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011;52(1):158-74.

  10. Blümcke I. Neuropathology of focal epilepsies: A critical review. Epilepsy Behav. 2009;15:34-9.

  11. Blumcke I, Spreafico R. Haaker G. Coras R, Kobow K, Bien C.G, et al. Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery. N Engl J Med. 2017;377:1648-56.

  12. Tassi L, Colombo N, Garbelli R, Lo Russo G, Mai R, Cardinale F, et al. Focal cortical dysplasia: Neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain. 2002;125:1719-32.

  13. Tassi L, Garbelli R, Colombo N, Bramerio M, Lo Russo G, Mai R, et al. Electroclinical, MRI and surgical outcomes in 100 epileptic patients with type II FCD. EpilepticDisord. 2012;14(3): 257-66.

  14. Kabat J, Przemystaw K. Focal cortical displasia – review.Pol J Radiol. 2012;77 (2): 35-43.

  15. Lerner JT, Salamon N, Hauptman JS, Velasco TR, Hemb M, Wu JY, et al. Assessment and surgical outcomes for mild type I and severe type II cortical dysplasia: A critical review and the UCLA experience. Epilepsia. 2009;50(6):1310-35.

  16. Tassi L, Garbelli R, Colombo N, Bramerio M, Lo Russo G, Deleo F, et al. Type I focal cortical displasia (FCD I): surgical outcome is related to histopathology. Epileptic Disord. 2010; 12 (3):1-

  17. Sun Y, Wang X, Che N, Qin H, Liu S, Wu X, el al. Clinical characteristics and epilepsy outcomes following surgery caused by focal cortical dysplasia (type IIa) in 110 adult epileptic patients. Exp Ther Med. 2017;13(5):2225-34.

  18. Villarejo-Ortega FJ, Álvarez-Linera Prado J, Pérez-Jiménez MA. Cirugía de la epilepsia en niños con displasias corticales focales. RevNeurol. 2013;57(Supl 1): S221-S27.




2020     |     www.medigraphic.com