We investigated the anatomo-electro-clinical features and clinical outcome of surgical resections strictly confined to the parietal lobe in 40 consecutive patients who received surgery for pharmacoresistant seizures. The population was subcategorized into a paediatric (11 subjects; mean age at surgery: 7.2+/-3.7 years) and an adult group (29 patients; mean age at surgery: 30+/-10.8 years). The paediatric group more frequently exhibited personal antecedents, neurological impairment, high seizure frequency, and dysplastic lesions. Nonetheless, compared with adults, children had better outcome and more frequently reached definitive drug discontinuation after surgery. After a mean follow-up of 9.4 years (range: 3.1-16.7), 30 subjects (75%) were classified as Engel Class I. The presence of multiple types of aura in the same patient, aswell as a high incidence of secondary generalization, represented a characteristic feature of parietal seizures and did not correlate negatively with surgical outcome. A total resection of the epileptogenic zone and a localizing/regional interictal EEGwere statistically significant predictive factors of outcome. Intracerebral investigation, performed in 55% of cases, contributed to complete tailored resections of the epileptogenic area and determination of prognosis. Frequent subjective manifestations of parietal lobe seizures, such as vertiginous, cephalic and visual-moving sensations, underscore their potential misdiagnosis as non-epileptic events.

Francione, S., Liava, A., Mai, R., Nobili, L., Sartori, I., Tassi, L., et al. (2015). Drug-resistant parietal epilepsy: Polymorphic ictal semiology does not preclude good post-surgical outcome. EPILEPTIC DISORDERS, 17(1), 32-46 [10.1684/epd.2015.0728].

Drug-resistant parietal epilepsy: Polymorphic ictal semiology does not preclude good post-surgical outcome

LIAVA, ALEXANDRA
Primo
;
SCARPA, PINA;
2015

Abstract

We investigated the anatomo-electro-clinical features and clinical outcome of surgical resections strictly confined to the parietal lobe in 40 consecutive patients who received surgery for pharmacoresistant seizures. The population was subcategorized into a paediatric (11 subjects; mean age at surgery: 7.2+/-3.7 years) and an adult group (29 patients; mean age at surgery: 30+/-10.8 years). The paediatric group more frequently exhibited personal antecedents, neurological impairment, high seizure frequency, and dysplastic lesions. Nonetheless, compared with adults, children had better outcome and more frequently reached definitive drug discontinuation after surgery. After a mean follow-up of 9.4 years (range: 3.1-16.7), 30 subjects (75%) were classified as Engel Class I. The presence of multiple types of aura in the same patient, aswell as a high incidence of secondary generalization, represented a characteristic feature of parietal seizures and did not correlate negatively with surgical outcome. A total resection of the epileptogenic zone and a localizing/regional interictal EEGwere statistically significant predictive factors of outcome. Intracerebral investigation, performed in 55% of cases, contributed to complete tailored resections of the epileptogenic area and determination of prognosis. Frequent subjective manifestations of parietal lobe seizures, such as vertiginous, cephalic and visual-moving sensations, underscore their potential misdiagnosis as non-epileptic events.
Articolo in rivista - Articolo scientifico
Epilepsy surgery; Extratemporal epilepsy; Ictal semiology; Parietal epilepsy; Surgical outcome; Adolescent; Adult; Age of Onset; Aged; Child; Child, Preschool; Drug Resistance; Electroencephalography; Epilepsy; Female; Follow-Up Studies; Humans; Infant; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Seizures; Treatment Outcome; Young Adult; Parietal Lobe; Neurology (clinical); Neurology; Medicine (all)
English
2015
17
1
32
46
reserved
Francione, S., Liava, A., Mai, R., Nobili, L., Sartori, I., Tassi, L., et al. (2015). Drug-resistant parietal epilepsy: Polymorphic ictal semiology does not preclude good post-surgical outcome. EPILEPTIC DISORDERS, 17(1), 32-46 [10.1684/epd.2015.0728].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/94412
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