Predictors and outcome surgery for posterior cortex epilepsies

Abstract

ObjectiveThe aim of this study is to identify the prognostic role of MRI and EEG in posterior cortex epilepsies (PCES) and to characterize their clinical features. Patient and MethodsWe retrospectively studied 54 consecutive patients (18 females, 36 males) from April 2011 to November 2015, who had undergone PCES surgery. Electro-clinical, pathological and surgical data were evaluated. Of the patients, 18 (33.3%) patients underwent a cortical resection (corticectomy), 10 (18.5%) lobectomy, 6 (11.1%) multilobar resection, 20 (30.1%) disconnection. ResultsThe postoperative follow-up duration was ≥1 year in all patients (12–44 months, mean = 25). Thirty-two patients (59.3%) became seizure free (ILAE 1) and 40 (74.1%) had a good (ILAE 1, 2, 3) outcome. The most common pathological finding was focal cortical dysplasia (in 34 patients). Univariate analysis showed that regional scalp interictal epilepsy discharges (IEDs) (P = 0.031), Regional EEG onset (P = 0.027), a MRI lesion (P = 0.001) and the number of seizures that were recorded by the epilepsy monitor unit (P = 0.016) were significantly associated with freedom from seizures. Multivariate analysis confirmed that MRI positive was statistically significant (HR = 4.284, CI = 1.198–15.315). ConclusionsSurgical treatment is effective for PCES, and MRI and EEG analyses are important in presurgical evaluation of PCES.