KOCHEN Sara Silvia
congresos y reuniones científicas
Non-lesional focal epilepsies: epileptogenic zone diagnosis using deep electrodes in a high complex public hospital
NASIMBERA A; ODDO S; GIAGANTE B; KOCHEN S; SOLIS P; D´ALESSIO L; COLLAVINI S; PRINCICH JP; SEOANE E1; SEOANE P
Congreso; Word Epilepsy Congress; 2019
Purpose: Epilepsy surgery is the most effective methodin the treatment of focal epilepsies when the epileptogenic zone (EZ) coincideswith lesion in the MRI and does not involve eloquent areas. In those caseswhere EZ is not identified by neuroimaging methods, the implantation of deepelectrodes is required for the adequate diagnosis of EZ. The aim of this studyis to perform a descriptive analysis of the EZ diagnoses and the post-surgicalevolution compared with the group of patients (p) with lesion in the MRI.Method: We analyzed the totality of patients implanted with deepelectrodes (SEEG), from the Video-EEG Unit of El Cruce Hospital "NestorCarlos Kirchner", from January 2014 to December 2018, and selected those pwithout 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 lesionin the MRI. Four p. were implanted with deep electrodes in both mesial temporalregions. Two p, was bilateral temporal and prefrontal deep electrodes. Theremaining p was explored in the posterior temporal region and right parietal.In 5 p surgery was indicated and 1 p remained seizure free. In 4 p we observedimprove on seizures frequency. Compared with the population with a lesion inthe MRI that was operated (12p), 4 p remain seizure free, 6 continued withlower seizure frequency and 2 p with sporadic seizures(p < .05). Conclusion: Post surgical evolution compared with the group of patientswith lesion in the MRI, did not present significant differences. In the groupof patients with focal drug resistant epilepsy without lesion in MRI, it isessential to perform SEEG with a multidisciplinary approach for a correctdiagnosis of EZ and adequate response to surgical treatment.