Proportion of resected seizure onset zone contacts in pediatric stereo-EEG-guided resective surgery does not correlate with outcome.
Clin Neurophysiol
; 138: 18-24, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35364463
ABSTRACT
OBJECTIVE:
We aimed to determine whether the proportion of putative seizure onset zone (SOZ) contacts resected associates with seizure outcome in a cohort of children undergoing stereoelectroencephalography (SEEG)-guided resective epilepsy surgery.METHODS:
Patients who underwent SEEG-guided resective surgery over a six-year period were included. The proportion of SOZ contacts resected was determined by co-registration of pre- and post-operative imaging. Outcome was classified as seizure free (SF, Engel class I) or not seizure-free (NSF, Engel class II-IV) at last clinical follow-up.RESULTS:
Twenty-nine patients underwent resection of whom 22 had sufficient imaging data for analysis (median age at surgery of 10 years, range 5-18). Fifteen (68.2%) were SF at median follow-up of 19.5 months (range 12-46). On univariate analysis, histopathology, was the only significant factor associated with SF (p < 0.05). The percentage of defined SOZ contacts resected ranged from 25-100% and was not associated with SF (p = 0.89). In a binary logistic regression model, it was highly likely that histology was the only independent predictor of outcome.CONCLUSIONS:
The percentage of SOZ contacts resected was not associated with SF in children undergoing SEEG-guided resective epilepsy surgery.SIGNIFICANCE:
Factors such as spatial organisation of the epileptogenic zone, neurophysiological biomarkers and the prospective identification of pathological tissue may therefore play an important role.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Epilepsia
/
Epilepsia Resistente a Medicamentos
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article