Non- Lesional Focal Epilepsies: Epileptogenic Zone Diagnosis Using Deep Electrodes In A High Complex Public Hospital

A. NASIMBERA; S.ODDO; B. GIAGANTE; P.SOLIS; L. D′ALESSIO; S. COLLAVINI; J.P. PRINCICH; E.SEOANE; P.SEOANE; S. KOCHEN

Bangkok

Congreso; 33rd International Epilepsy Congres 2019; 2019

Purpose : Epilepsy surgery is the most effective method inthe treatment of focal epilepsies when the epileptogenic zone(EZ) coincides with lesion in the MRI and does not involveeloquent areas. In those cases where EZ is not identified byneuroimaging methods, the implantation of deep electrodesis required for the adequate diagnosis of EZ. The aim of thisstudy is to perform a descriptive analysis of the EZ diagnosesand the post- surgical evolution compared with the group ofpatients (p) with lesion in the MRI.Method : We analyzed the totality of patients implanted withdeep electrodes (SEEG), from the Video- EEG Unit of ElCruce Hospital ?Nestor Carlos Kirchner?, from January 2014to December 2018, and selected those p without MRI lesion.We compared post surgical evolution of this selected groupwith the those p with MRI lesion.Results : From 30 p with deep electrodes (SEEG), 7 p (23%)had no lesion in the MRI. Four p. were implanted with deepelectrodes in both mesial temporal regions. Two p, was bilateraltemporal and prefrontal deep electrodes. The remaining p wasexplored in the posterior temporal region and right parietal. In5 p surgery was indicated and 1 p remained seizure free. In4 p we observed improve on seizures frequency. Comparedwith the population with a lesion in the MRI that was operated(12p), 4 p remain seizure free, 6 continued with lower seizurefrequency and 2 p with sporadic seizures (p < .05).Conclusion : Post surgical evolution compared with thegroup of patients with lesion in the MRI, did not presentsignificant differences. In the group of patients with focaldrug resistant epilepsy without lesion in MRI, it is essential toperform SEEG with a multidisciplinary approach for a correctdiagnosis of EZ and adequate response to surgical treatment.