Outcome of resective surgery for intractable partial epilepsy guided by subdural electrode arrays

P. Jennum, A. Dhuna, K. Davies, M. Fiol, R. Maxwell

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

The aim of this paper was to evaluate the outcome and the factors predictive for a good prognosis of resective surgery for intractable partial epilepsy guided by subdural electrode arrays (SEA's) and operative electrocorticography. Sixty‐four patients, aged 8–52 years, were evaluated with chronic SEAs in order to record interictal and ictal activity and delineate speech and motor areas by functionally mapping. Resection were individualized to each patient's SEA recorded electrocorticogram and operative electrocorticogram and functional mapping results (tailored resection). The follow‐up time was a minimum of one year. Good seizure outcome was defined as seizure free from complex partial and secondary generalized seizures. After one year 70% of the patients with a temporal ictal focus was seizure free compared to 55% of the patients with an extratemporal focus. Complete resection of interictal or ictal fields as mapped with SEAs, gave better prognosis than partial resection. Patients with no postresection spikes had a better prognosis than patients with residual postresection spikes evaluated with operative electrocorticography. Sex, age, duration of epilepsy prior to surgery, extent of temporal lobe resection and structural abnormalities determined by MRI were not associated with a favorable seizure outcome after surgery. We conclude that complete resection of the interictal and ictal field mapped with SEA's and absence of postresection spikes on operative electrocorticography are associated with an excellent seizure outcome.

Original languageEnglish (US)
Pages (from-to)434-437
Number of pages4
JournalActa Neurologica Scandinavica
Volume87
Issue number6
DOIs
StatePublished - Jun 1993

Keywords

  • Key words: invasive electrophysiology
  • electrocorticography
  • partial epilepsy
  • prognosis
  • subdural electrodes
  • surgery

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