Is postresective intraoperative electrocorticography predictive of seizure outcomes in children? Clinical article

被引:41
作者
Wray, Carter D. [6 ]
McDaniel, Sharon S. [6 ]
Saneto, Russell P. [6 ]
Novotny, Edward J., Jr. [1 ,2 ,3 ,4 ,5 ,6 ]
Ojemann, Jeffrey G. [2 ]
机构
[1] Univ Washington, Dept Pediat, Seattle, WA 98195 USA
[2] Univ Washington, Dept Neurosurg, Seattle, WA 98195 USA
[3] Univ Washington, Dept Radiol, Seattle, WA 98195 USA
[4] Seattle Childrens Hosp, Div Pediat Neurol, Seattle, WA USA
[5] Seattle Childrens Hosp, Div Pediat Neurosurg, Seattle, WA USA
[6] Univ Washington, Dept Neurol, Seattle, WA 98195 USA
关键词
epilepsy surgery; intraoperative electrocorticography; postresective; neocortical; extratemporal; TEMPORAL-LOBE EPILEPSY; INTRACTABLE EPILEPSY; NEOCORTICAL EPILEPSY; SURGICAL-TREATMENT; TUMOR RESECTION; SURGERY; GANGLIOGLIOMAS; SPIKES; LONG; SCLEROSIS;
D O I
10.3171/2012.1.PEDS11441
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Intraoperative electrocorticography (ECoG) is commonly used to guide the extent of resection, especially in lesion-associated intractable epilepsy. Interictal epileptiform discharges on postresective ECoG (post-ECoG) have been predictive of seizure recurrence in some studies, particularly in adults undergoing medial temporal lobectomy, frontal lesionectomy, or low-grade glioma resection. The predictive value of postresective discharges in pediatric epilepsy surgery has not been extensively studied. Methods. The authors retrospectively examined the charts of all 52 pediatric patients who had undergone surgery with post-ECoG and had more than 1 year of follow-up between October 1, 2003, and October 1, 2009. Results. Of the 52 pediatric patients, 37 patients showed residual discharges at the end of their resection and 73% of these patients were seizure free, whereas 15 patients had no residual discharges and 60% of them were seizure-free, which was not significantly different (p = 0.36, chi-square). Conclusions. Electrocorticography-guided surgery was associated with excellent postsurgical outcome. Although this sample size was too small to detect a subtle difference, absence of epileptiform discharges on post-ECoG does not appear to predict seizure freedom in all pediatric patients referred for epilepsy surgery. Future studies with larger study samples would be necessary to confirm this finding and determine whether post-ECoG may be useful in some subsets of pediatric epilepsy surgery candidates. (http://thejns.org/doi/abs/10.3171/2012.1.PEDS11441)
引用
收藏
页码:546 / 551
页数:6
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