Prognostic Role of Functional Neuroimaging after Multilobar Resection in Patients with Localization-Related EpilepsyReport as inadecuate




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To investigate the usage of functional neuroimaging as a prognostic tool for seizure recurrence and long-term outcomes in patients with multilobar resection, we recruited 90 patients who received multilobar resections between 1995 and 2013 with at least 1-year follow-up mean 8.0 years. All patients were monitored using intracranial electroencephalography EEG after pre-surgical evaluation. Clinical data demographics, electrophysiology, and neuroimaging were reviewed retrospectively. Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study. After 1 year, 56 patients 62.2% became Engel class I and at the last follow-up, 47 patients 52.2% remained seizure-free. Furthermore, non-localized 18F-fluorodeoxyglucose positron emission tomography PET, identifying hypometabolic areas not concordant with ictal onset zones, significantly correlated with seizure recurrence after 1 year. Non-lesional magnetic resonance imaging MRI and left-sided resection correlated with poor outcomes. In the last follow-up, non-localized PET and left-sided resection significantly correlated with seizure recurrence. Both localized PET and ictal-interictal SPECT subtraction co-registered to MR SISCOM predicted good surgical outcomes in the last follow-up 69.2%, Engel I. This study suggests that PET and SISCOM may predict postoperative outcomes for patients after multilobar epilepsy and shows comparable long-term surgical outcomes after multilobar resection.



Author: Eun Bin Cho, Eun Yeon Joo , Dae-Won Seo, Seung-Chyul Hong, Seung Bong Hong

Source: http://plos.srce.hr/



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