Seizure Outcome of Patients with Magnetic Resonance Imaging–Negative Epilepsies: Still An Ongoing Debate

Cihan Isler; Cigdem Ozkara; Baris Kucukyuruk; Sakir Delil; Buge Oz; Nil Comunoglu; Osman Kizilkilic; Ahmet Kayhan; Kaancan Deniz; Serdar Akkol; Taner Tanriverdi; Mustafa Uzan

doi:10.1016/j.wneu.2017.07.046

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Seizure Outcome of Patients with Magnetic Resonance Imaging–Negative Epilepsies: Still An Ongoing Debate

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Seizure Outcome of Patients with Magnetic Resonance Imaging–Negative Epilepsies: Still An Ongoing Debate

Cihan Isler, Cigdem Ozkara, Baris Kucukyuruk, Sakir Delil, Buge Oz, Nil Comunoglu, Osman Kizilkilic, Ahmet Kayhan, Kaancan Deniz, Serdar Akkol, …

World neurosurgery, Vol.106, pp.638-644

10/2017

DOI: 10.1016/j.wneu.2017.07.046

PMID: 28735141

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Abstract

Surgical results regarding MRI-negative epilepsy were presented and related clinical and histopathological parameters were discussed. Thirty-six MRI-negative epilepsy patients were retrospectively analyzed. Histopathological specimens were re-reviewed by 2 blind neuropathologists and re-classified based on the current classifications. The mean age at surgery and seizure onset was 24.5 years and 9.3 years, respectively. Eight patients were younger than 18 years. Mean duration of seizures was 15.3 years. All but 2 underwent invasive monitorization. Eighteen patients had hypometabolism on FDG-PET with temporal lobe involvement in majority (66.7%). Hypometabolism was found in all patients with hippocampal sclerosis (HS), which was present in 50% and 66.7% of focal cortical dysplasia (FCD) type I and II patients, respectively. The frontal lobe resection was the most frequent type of operation followed by resections in temporal, parietal and occipital lobes. In 7 patients, multilobar resection was performed. Histopathological diagnosis was FCD type I, II, III, HS, and gliosis in 14, 12, 2, 3 and 2 patients, respectively. The mean follow-up was 5.8 years. Seventeen patients were seizure free and favorable outcome (Engel's I and II) was found in 69.7%. FCD type I tend to have more favorable seizure outcome. Duration of epilepsy and hypometabolism on FDG-PET was significantly related to outcome, whereas involved lobe was not. Our results suggest it is worth pursuing resective surgery in adults as well as in children with drug-resistant epilepsy with normal MRI.

Epilepsy surgery

Focal cortical dysplasia

MRI-negative

Positron emission tomography

Seizure outcome

Details

Title: Subtitle: Seizure Outcome of Patients with Magnetic Resonance Imaging–Negative Epilepsies: Still An Ongoing Debate
Creators: Cihan Isler - Istanbul University
Cigdem Ozkara - Istanbul University
Baris Kucukyuruk - Istanbul University
Sakir Delil - Boston Applied Technologies (United States)
Buge Oz - Istanbul University
Nil Comunoglu - Istanbul University
Osman Kizilkilic - Istanbul University
Ahmet Kayhan - Istanbul University
Kaancan Deniz - Istanbul University
Serdar Akkol - Istanbul University
Taner Tanriverdi - Istanbul University
Mustafa Uzan - Istanbul University
Resource Type: Journal article
Publication Details: World neurosurgery, Vol.106, pp.638-644
DOI: 10.1016/j.wneu.2017.07.046
PMID: 28735141
ISSN: 1878-8750
eISSN: 1878-8769
Publisher: Elsevier Inc
Number of pages: 7
Language: English
Date published: 10/2017
Academic Unit: Neurology
Record Identifier: 9985180929102771

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