Impacto de la experiencia sobre los resultados quirúrgicos en la epilepsia del lóbulo temporal

Abstract

Introduction. Recently, we have published the results of a first surgical series of patients with temporal lobe epilepsy (TLE). We describe a posterior series of patients intervened of TLE, we compare the functional results with the previous series and we finally analyze the causes of changes. Patients and methods. We studied the first 22 consecutive patients surgically intervened of TLE with a minimum post-surgery follow-up of 2 years. Patients showing I and II Engel's grade were used as gold standard for evaluation of pre-surgical complementary studies. Results. We have obtained better functional results: 91% patients showing Engel's grade I, 9% showing grade II and neither III nor IV grades were obtained. Pre-surgical studies changed in comparison with the previous report. The most improving change was observed in video-EEG with foramen-ovale electrodes (FOE) (37%), scalp EEG (26.6%), interictal SPECT (11.7%) and MRI (11.7%). Video-EEG with FOE was the study than showed greater concordance with epileptic focus (95.5%), followed by EEG (86.4%). In 35% of cases, MRI was normal or without valid data for correct localization of focus. Conclusions. Video-EEG with FOE and TLE surgery are safety methods, which results improve with the experience. Normal or not informative MRI do not should a priori reject those patients with drug-resistant TLE from surgery.

Impaired mesial synchronization in temporal lobe epilepsy

“…Informed consent was obtained from all patients. Patients were evaluated pre-surgically according to La Princesa's protocol, as published elsewhere (Pastor et al, 2005;Sola et al, 2005). Briefly, all patients were studied with interictal single photon emission computer tomography (SPECT), magnetic resonance imaging (MRI) 1.5 T, scalp EEG and video-electroencephalography (v-EEG) using 19 scalp electrodes according to the international 10-20 system.…”

Identification of redundant and synergetic circuits in triplets of electrophysiological data

“…The reference electrode was placed on the contralateral ear and in some cases it was moved to the nearby scalp in order to verify there was no contamination of the recording, consistent with previous studies [19]. A presurgical evaluation was carried out according to the protocol used at La Princesa hospital, as reported previously [20].…”

Asociación entre los polimorfismos genéticos de nucleótido único en genes transportadores ABC con la epilepsia farmacorresistente en la población española

“…Se les realizó un electroencefalograma interictal y protocolo de epilepsia de resonancia magnética craneal. Al grupo de casos se le estudi ó según el protocolo de la Unidad de Referencia de Epilepsia del Sistema Nacional de Salud del Hospital Universitario de La Princesa [ 13 ]. Se comparó a 227 pacientes con epilepsia farmacorresistente (tratados con cirugía resectiva o neuroestimulación) con 100 pacientes con epilepsia farmacocontrolada (libres de crisis durante al menos un año).…”