Intractable occipital lobe epilepsy: clinical characteristics and surgical treatment.
Epilepsia
; 51(11): 2334-7, 2010 Nov.
Article
em En
| MEDLINE
| ID: mdl-20662891
ABSTRACT
Intractable occipital lobe epilepsy remains a surgical challenge. Clinical characteristics of 14 patients were analyzed. Twelve patients had surgery, seven patients had visual auras (50%) and only eight patients (57%) had posterior scalp EEG changes. Ictal single-proton emission computed tomography (SPECT) incorrectly localized in 7 of 10 patients. Six patients (50%) had Engel's class I outcome. Patients with inferior occipital seizure onset appeared to fare better (three of four class I) than patients with lateral or medial occipital seizure onset (three of eight class I). Patients who had all three occipital surfaces covered with electrodes had a better outcome (four of five class I) than patients who had limited electroencephalography (EEG) coverage (two of seven class I). Magnetic resonance imaging (MRI) lesions did not guarantee a seizure free outcome. In conclusion, visual auras, scalp EEG, and imaging findings are not reliable for correct identification of occipital onset. Occipital seizure onset can be easily missed in nonlesional epilepsy. Comprehensive intracranial EEG coverage of all three occipital surfaces leads to better outcomes.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Processamento de Sinais Assistido por Computador
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Imageamento por Ressonância Magnética
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Tomografia Computadorizada de Emissão de Fóton Único
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Epilepsias Parciais
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Imageamento Tridimensional
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Eletroencefalografia
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Lobo Occipital
Tipo de estudo:
Etiology_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article