Successful surgery for epilepsy due to early brain lesions despite generalized EEG findings

Wyllie, Elaine; Lachhwani, Deepak; Gupta, Ajay; Adina, Chirla; Cosmo, G. Di; Worley, S.; Kotagal, Prakash; Ruggieri, Paul; Bingaman, William

doi:10.1212/01.wnl.0000266386.55715.3f

Cited by 296 publications

(235 citation statements)

References 33 publications

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“…3 However, surgery relies on accurate lesion localization, so good-quality imaging is important for preoperative planning to allow complete resection. [4][5][6] Histologically, oligodendroglial hyperplasia is characterized by an increased number of normal-appearing oligoden- droglial cells in the cortex and juxtacortical white matter. It is considered at the mildest end of the spectrum of neuronal migrational disorders or microdysgenesis.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging Identification of Oligodendroglial Hyperplasia

Hamilton¹,

Nesbit²

2009

AJNR Am J Neuroradiol

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SUMMARY:We report a case of oligodendroglial hyperplasia detected by using high-resolution highfield MR imaging. This disorder is considered part of the spectrum of cortical migrational abnormalities and is found with increased incidence in patients with epilepsy. Surgery offers the best chance for cure in patients with medically refractory partial complex epilepsy. Accurate localization and detection of the full lesion extent by using a high-resolution imaging technique such as 3T MR imaging is important to surgical success. Detection of subtle dysplastic lesions such as oligodendroglial hyperplasia may be clinically relevant.

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Section: Discussionmentioning

confidence: 99%

MR Imaging Identification of Oligodendroglial Hyperplasia

Hamilton¹,

Nesbit²

2009

AJNR Am J Neuroradiol

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“…The scalp video-EEG recordings in children often show secondary bilateral synchrony, generalized or multifocal interictal discharges (Wyllie et al, 2007). We have to find (1) consistent leading discharges before these spread to the whole brain, (2) predominant lateralization of multiple independent spike foci, and (3) complexity of spike morphology.…”

Section: Scalp Video-eeg Monitoringmentioning

confidence: 99%

“…EEGs often show paroxysmal generalized spike-/polyspike-and-wave complexes in children with intractable partial epilepsy even with focal onset seizures (Wyllie et al, 2007). Frontal lobe epilepsy frequently presents with secondarily bilateral synchronized epileptiform discharges (Akiyama et al, 2011).…”

Section: Secondary Bilateral Synchrony In Frontal Lobe Epilepsymentioning

confidence: 99%

Clinical MEG Analyses for Children with Intractable Epilepsy

Ochi¹,

Go²,

Otsubo³

2011

Magnetoencephalography

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“…Büyük çocuk ve adelösan yaş grubunda da fokal lezyonlara eşlik eden jeneralize EEG bulguları bildirilmiş, bu lezyonların yaklaşık %90'ının konjenital ya da erken dönemde kazanılmış lezyonlar (kortikal gelişim malformasyonları, infarkt, enfeksiyon ve travma sonrası gelişen kistik ensefalomalaziler) olduğu görülmüştür. [23,24] Bu çocuklarda cerrahi sonrası tam nöbetsizlik oranı, benzer lezyonları olan ve fokal EEG anormallikleri gösteren çocuklarla karşılaştırıldığında cerrahi sonrası prognoz açısından birbirine yakın sonuçlar elde edildiği görülmüştür.…”

Section: çOcukluk çAğında Epilepsi Cerrahisi öNcesi Değerlendir-meunclassified

Intractable Epilepsy in Childhood: Presurgical Evaluation and Treatment

Yalnızoğlu¹

2016

Epilepsi

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ÖzetÇocukluk çağı epilepsilerinde erken tedavi ile nöbet kontrolünün sağlanması, tekrarlayan nöbetlere bağlı nöronal hasarın engellenmesi, normal gelişimin yakalanması, ilaç yan etkilerinin en aza indirilmesi ve hayat kalitesinin artırılması açısından büyük önem taşır. Dirençli epilepsinin tedavi seçenekleri arasında epilepsi cerrahisi son yıllarda giderek artan bir ağırlık kazanmıştır. Ekstratemporal epilepsilerin oranının daha fazla olması, etyolojide gelişimsel lezyonların öne çıkması nedeniyle pediatrik epilepsi popülasyonu erişkin yaş grubuna oranla daha refrakter bir profil çizer. Bununla birlikte epilepsi cerrahisi sonuçlarının nöbet kontrolü açısından erişkin ve çocuk yaş grubunda benzer sonuçlar verdiği gösterilmiştir; yetişkinlerde olduğu gibi süt çocuğu yaş grubu dahil çocukluk çağında da başarıyla uygulanabilmektedir. Bu yazıda çocukluk çağı epilepsilerinde epilepsi cerrahisi uygulamaları tartışılacaktır.Anahtar sözcükler: Çocuklar; dirençli; epilepsi; epilepsi cerrahisi. SummaryIn childhood, early treatment and management of seizures are essential to prevent neuronal injury owing to intractable seizures, as well as achieving normal development, minimizing the adverse effects of antiepileptic drugs, and improving quality of life. Epilepsy surgery has become an important option in the treatment of intractable epilepsy. Children with intractable epilepsy have a more refractory profile compared to adults due to the higher rates of extratemporal epilepsies and develeopmental lesions as the underlying etiology. However, both adults and children have similar outcome following epilepsy surgery, and surgical treatment is efficiently applied in pediatric patients including infants. This paper reviews presurgical evaluation in children with intractable epilepsy and summarizes treatment modalities.

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Successful surgery for epilepsy due to early brain lesions despite generalized EEG findings

Cited by 296 publications

References 33 publications

MR Imaging Identification of Oligodendroglial Hyperplasia

MR Imaging Identification of Oligodendroglial Hyperplasia

Clinical MEG Analyses for Children with Intractable Epilepsy

Intractable Epilepsy in Childhood: Presurgical Evaluation and Treatment

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