Patients with epileptic seizures and cerebral lesions who underwent lesionectomy restricted to or associated with the adjacent irritative area

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Data
1999-07-01
Autores
Rassi Neto, Aziz [UNIFESP]
Ferraz, Fernando Patriani [UNIFESP]
Campos, Carlos R.
Braga, Fernando Menezes [UNIFESP]
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Purpose: To analyze the best surgical procedure for patients with epileptic seizures and cerebral lesions-i.e., resection restricted to the lesion or resection associated with the adjacent irritative area-based on the clinical evolution of patients' seizure outcome and electroencephalographic (EEG) and electrocorticographic (ECoG) findings.Methods: This study comprised 37 patients with epileptic seizures and cerebral lesions, ranging in age from 9 to 66 years. Patients were divided into two groups: Group 1 consisted of 21 patients with medically intractable epilepsy, Group 2 of 16 patients with medically controlled epilepsy. Eleven of the 21 patients in Group 1 (Subgroup A) underwent surgical resection of the cerebral lesion and adjacent irritative area as shown by ECoG. for the remaining 10 patients in Group 1 (Subgroup B), the resection was restricted to the lesion. the 16 patients in Group 2 all underwent lesionectomies.Results: of the 11 patients in group 1 who underwent resection of the cerebral lesion and adjacent irritative area, 91% became seizure free. Sixty percent of the remaining patients in group 1 whose resections were restricted to the lesion also became seizure free, as did all the patients in group 2. An overall analysis of the EEGs for all patients showed a statistically significant decrease in paroxysmal activity.Conclusions: in patients with uncontrolled seizures, resection of the cerebral lesion associated with the irritative area shows a tendency to obtain better seizure-outcome results than restricted lesionectomy.
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Epilepsia. Philadelphia: Lippincott Williams & Wilkins, v. 40, n. 7, p. 856-864, 1999.