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Clinical and neurophysiological correlations in patients with refractory partial epilepsy and intracranial structural lesions

Paul Boon UGent, Luc Calliauw, Jacques De Reuck, I Hoksbergen, Eric Achten UGent, Evert Thiery, Jacques Caemaert, A De Somer and D DECOO (1994) ACTA NEUROCHIRURGICA. 128(1-4). p.68-83
abstract
Twenty patients (13 males, 7 females), who presented with refractory partial epilepsy and a CT and/or MR detected intracranial intra-axial structural lesion were admitted to the University of Gent Epilepsy Monitoring Unit. Mean duration of the epilepsy was 17 years (2-47 years). All patients were enrolled in a comprehensive presurgical protocol including neurological examination, video-scalp-EEG monitoring with prolonged interictal and ictal recording, neuropsychological assessment and positron emission tomography (PET). Intracranial EEG monitoring was performed in 5 patients in whom discrepancies between different tests were found during the non-invasive evaluation. Clinical neurological examination was normal in 16 patients; 4 patients had a mild contralateral hemiparesis. Lesions were mainly located in the temporal lobe (55%). Most patients presented with complex partial seizures (90%). Clinical seizure characteristics correlated well with the lesion location in 55% of patients. Interictal EEG showed focal epileptic activity and focal slowing in respectively 85% and 30% of patients. Interictal EEG lateralization was congruent with the side of the lesion in 17 patients (85%). Interictal EEG localization was congruent with the lobe of the lesion in 13 patients (65%). Ictal EEG lateralized correctly in 14 patients (70%) and localized correctly in 10 patients (50%). Neuropsychological assessment lateralized and localized congruently in respectively 8/17 (47%) and 7/17 (41%) of patients. Interictal PET showed focal interictal hypometabolism, congruent with the lesion, in 13/16 (81%) of patients. Intracranial EEG was congruent with the lesion location in 3 patients but non-congruent in 2 patients. All patients underwent surgical procedures: average follow-up was 14 months (6-24 months). Complete surgical removal of the lesion with free margins resulted in a more than 90% reduction of seizures without postoperative neurological deficit in 12/13 patients.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
CHILDREN, SURGERY, LOCALIZATION, PATHOLOGY, CHILDHOOD, LOW-GRADE, SURGICAL-MANAGEMENT, BRAIN-TUMORS, INTRACTABLE PARTIAL SEIZURES, TEMPORAL-LOBE EPILEPSY
journal title
ACTA NEUROCHIRURGICA
Acta Neurochir.
volume
128
issue
1-4
pages
68 - 83
Web of Science type
Article
ISSN
0001-6268
DOI
10.1007/BF01400655
language
English
UGent publication?
yes
classification
A1
id
198546
handle
http://hdl.handle.net/1854/LU-198546
date created
2004-01-14 13:42:00
date last changed
2016-12-19 15:38:11
@article{198546,
  abstract     = {Twenty patients (13 males, 7 females), who presented with refractory partial epilepsy and a CT and/or MR detected intracranial intra-axial structural lesion were admitted to the University of Gent Epilepsy Monitoring Unit. Mean duration of the epilepsy was 17 years (2-47 years). All patients were enrolled in a comprehensive presurgical protocol including neurological examination, video-scalp-EEG monitoring with prolonged interictal and ictal recording, neuropsychological assessment and positron emission tomography (PET). Intracranial EEG monitoring was performed in 5 patients in whom discrepancies between different tests were found during the non-invasive evaluation. Clinical neurological examination was normal in 16 patients; 4 patients had a mild contralateral hemiparesis. Lesions were mainly located in the temporal lobe (55\%). Most patients presented with complex partial seizures (90\%). Clinical seizure characteristics correlated well with the lesion location in 55\% of patients. Interictal EEG showed focal epileptic activity and focal slowing in respectively 85\% and 30\% of patients. Interictal EEG lateralization was congruent with the side of the lesion in 17 patients (85\%). Interictal EEG localization was congruent with the lobe of the lesion in 13 patients (65\%). Ictal EEG lateralized correctly in 14 patients (70\%) and localized correctly in 10 patients (50\%). Neuropsychological assessment lateralized and localized congruently in respectively 8/17 (47\%) and 7/17 (41\%) of patients. Interictal PET showed focal interictal hypometabolism, congruent with the lesion, in 13/16 (81\%) of patients. Intracranial EEG was congruent with the lesion location in 3 patients but non-congruent in 2 patients. 
All patients underwent surgical procedures: average follow-up was 14 months (6-24 months). Complete surgical removal of the lesion with free margins resulted in a more than 90\% reduction of seizures without postoperative neurological deficit in 12/13 patients.},
  author       = {Boon, Paul and Calliauw, Luc and De Reuck, Jacques and Hoksbergen, I and Achten, Eric and Thiery, Evert and Caemaert, Jacques and De Somer, A and DECOO, D},
  issn         = {0001-6268},
  journal      = {ACTA NEUROCHIRURGICA},
  keyword      = {CHILDREN,SURGERY,LOCALIZATION,PATHOLOGY,CHILDHOOD,LOW-GRADE,SURGICAL-MANAGEMENT,BRAIN-TUMORS,INTRACTABLE PARTIAL SEIZURES,TEMPORAL-LOBE EPILEPSY},
  language     = {eng},
  number       = {1-4},
  pages        = {68--83},
  title        = {Clinical and neurophysiological correlations in patients with refractory partial epilepsy and intracranial structural lesions},
  url          = {http://dx.doi.org/10.1007/BF01400655},
  volume       = {128},
  year         = {1994},
}

Chicago
Boon, Paul, Luc Calliauw, Jacques De Reuck, I Hoksbergen, Eric Achten, Evert Thiery, Jacques Caemaert, A De Somer, and D DECOO. 1994. “Clinical and Neurophysiological Correlations in Patients with Refractory Partial Epilepsy and Intracranial Structural Lesions.” Acta Neurochirurgica 128 (1-4): 68–83.
APA
Boon, Paul, Calliauw, L., De Reuck, J., Hoksbergen, I., Achten, E., Thiery, E., Caemaert, J., et al. (1994). Clinical and neurophysiological correlations in patients with refractory partial epilepsy and intracranial structural lesions. ACTA NEUROCHIRURGICA, 128(1-4), 68–83.
Vancouver
1.
Boon P, Calliauw L, De Reuck J, Hoksbergen I, Achten E, Thiery E, et al. Clinical and neurophysiological correlations in patients with refractory partial epilepsy and intracranial structural lesions. ACTA NEUROCHIRURGICA. 1994;128(1-4):68–83.
MLA
Boon, Paul, Luc Calliauw, Jacques De Reuck, et al. “Clinical and Neurophysiological Correlations in Patients with Refractory Partial Epilepsy and Intracranial Structural Lesions.” ACTA NEUROCHIRURGICA 128.1-4 (1994): 68–83. Print.