Evolution of patients with surgically treated drug-resistant occipital lobe epilepsy

Abstract

Background: This study was to describe the evolution of patients who underwent surgical treatment of drug- resistant occipital lobe epilepsy (OLE) at our institution. Methods: We performed a retrospective analysis of data collected from electronic and paper clinical records of 20 patients who were diagnosed of OLE and underwent epilepsy surgery at our institution between 1998 and 2018. We also contacted patients by telephone and asked them to fill out a questionnaire about quality of life in epilepsy (QOLIE-10). Assembled data were analyzed using descriptive statistics. Results: The age at surgery ranged between 19 and 55 years. The period encompassing epilepsy onset and the date of surgery was variable. Semiology of seizures included visual symptoms in 75% of patients. In 90% of cases subdural grids, depth electrodes or a combination of both were used to plan the surgery. The most frequent neuroimaging and histopathological finding was cortical dysplasia (55%). The postoperative follow-up period was up to 15 years. The most common score on the Engel scale was I (70%). Visual deficits increased after surgery. Median score on QOLIE-10 questionnaire was 82.5 (interquartile range: 32.5). Conclusion: Surgical treatment of drug-resistant OLE offers hopeful results to those patients who have run out of pharmacological options and leads to postoperative deficits that are deemed expectable and occasionally acceptable.

Resection of bilateral occipital lobe lesions during a single operation as a treatment for bilateral occipital lobe epilepsy

“…The clinical manifestations of bilateral occipital lobe epilepsy in our cohort of 20 patients were elementary visual hallucinations, flashing lights, blurred vision, visual field defects, blindness, visual illusions, blinking, a sensation of eye movement, dizziness, and deja vu. These manifestations are typical of the visual and oculomotor symptoms of occipital lobe epilepsy reported by others[ 1 , 7 - 9 , 15 , 19 - 30 ]. Although the pathology underlying occipital lobe epilepsy can vary, the pathologic diagnoses made in our patients have also been reported previously[ 7 - 9 , 19 - 29 ].…”

“…Although pharmacologic therapies are available for focal epilepsy[ 14 ], some cases are resistant to drugs and require neurosurgical intervention[ 7 , 15 - 18 ]. A small number of reports have described the surgical management of intractable occipital lobe epilepsy, and the techniques used included lesionectomy, corticectomy, and lobectomy[ 7 - 9 , 15 , 17 , 19 - 29 ].…”

“…Although pharmacologic therapies are available for focal epilepsy[ 14 ], some cases are resistant to drugs and require neurosurgical intervention[ 7 , 15 - 18 ]. A small number of reports have described the surgical management of intractable occipital lobe epilepsy, and the techniques used included lesionectomy, corticectomy, and lobectomy[ 7 - 9 , 15 , 17 , 19 - 29 ]. However, the majority of previous clinical investigations have focused on patients with unilateral occipital lobe epilepsy, and there are very few published studies describing the surgical management of patients with bilateral occipital lobe epilepsy[ 30 ].…”

Fighting Epilepsy with Nanomedicines—Is This the Right Weapon?

“…Surgery is considered a highly effective therapeutic option for epilepsy, substantially improving cognition, behaviour, seizure control, and quality of life for patients. However, no epilepsy surgery should be carried out without preceding an in-depth evaluation [ 32 , 35 , 37 , 38 ]. Moreover, it has been described that after patients undergo the surgical procedure, about half of them require subsequent pharmacotherapy [ 32 , 35 ].…”