Clinical features of isolated and extended occipital lobe epilepsy and their surgical outcome comparison

Abstract

Objective To investigate the clinical features of isolated occipital lobe epilepsy (OLE, epileptogenic focus is confined to the occipital lobe) and extended OLE (epileptogenic focus also relates to the other lobes outside occipital lobe) to guide the clinical diagnosis and treatment. Methods A retrospective analysis was performed on the clinical data of 32 patients with OLE, admitted to our hospital from June 2011 to June 2013. And the patients were divided into 2 groups: isolated OLE (n=14) and extended OLE (n=18). The basic situation, seizure and diagnosis between patients in the two groups were compared. Results There were no significant differences in most clinical data between isolated and extended OLE patients, such as gender, disease duration, seizure type, premedication, localization diagnosis and surgical outcome (P>0.05). However, as compared with that in isolated OLE patients, non visual aura in extended OLE patients was more common, with significant difference (P 0.05). Patients underwent intracranial electrodes implanted EEG monitoring were all extended OLE ones, indicating that localization of epileptogenic focus were difficult. Satisfactory curative effect was achieved in 13 extended OLE patients (72%) and 12 isolated OLE patients (86%). Conclusion The localization diagnosis of extended OLE is more difficult than isolated OLE; however, satisfactory curative effect can be obtained in intractable OLE through integrated using many kinds of localization diagnosis methods (including intracranial electrode EEG), and accurate localization and effective resection of epileptogenic focus. Key words: Occipital lobe epilepsy; Surgical resection; Outcome