Focal neuronal migration disorders and intractable partial epilepsy: Results of surgical treatment

Annals of Neurology - Tập 30 Số 6 - Trang 750-757 - 1991
André Palmini1, F Andermann, A Olivier, Donatella Tampieri, Y. Robitaille
1Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada

Tóm tắt

AbstractTwenty‐six patients with focal or lateralized neuronal migration disorders and intractable partial epilepsy were treated surgically. Twenty‐four had reliable follow‐up ranging from 1 to 15 years (mean, 5.0). Pathologically, they fell into two categories: focal cortical dysplasia (12 patients) and forme fruste of tuberous sclerosis (8 patients). In the remaining 4 patients, the material was inadequate for histological analysis. Outcome regarding seizure control was assessed according to a classification most sensitive to variations in frequency of major attacks. Ten (42°) of the 24 patients achieved good or excellent outcome, 6(25°) had a worthwhile decrease in seizure frequency, and 8 (33°) had only discrete improvement. The variable most strongly correlated with surgical outcome was the amount of lesion removed. Seventy‐seven percent of patients in whom a complete excision or excision of 50° or more of the lesion was accomplished achieved excellent or good surgical outcome. Conversely, no patient with less than 50° of the lesion removed attained the same result. There was no correlation between other clinical, radiological, or electrographic variables and outcome regarding seizure control. Specifically there was no significant correlation between the amount of excision of the epileptogenic area as judged by scalp electroencephalography and electrocorticography studies, and surgical outcome. In patients with neuronal migration disorders and intractable partial epilepsy, removal of the structural abnormality takes precedence over removal of epileptogenic tissue as the main surgical strategy to achieve seizure control.

Từ khóa


Tài liệu tham khảo

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Thông tin xuất bản

Annals of Neurology

Tập 30 Số 6

750-757

Thông tin tác giả