Surgical outcomes and prognostic factors of drug‐resistant epilepsy secondary to encephalomalacia

Epilepsia ◽  
2019 ◽  
Vol 60 (5) ◽  
pp. 948-957
Author(s):  
Xinghui He ◽  
Feng Zhai ◽  
Yuguang Guan ◽  
Jian Zhou ◽  
Tianfu Li ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Outcomes ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals Prognostic factors for the development of drug-resistant epilepsy

2018 ◽  
Vol 1 (4) ◽  
pp. 164-168 ◽  
Author(s):  
Sara Yesenia Celorrio Castellano ◽  
Lisandra Palma Baños
Keyword(s):  
Prognostic Factors ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

scholarly journals Clinical factors predict surgical outcomes in pediatric MRI-negative drug-resistant epilepsy

Seizure ◽  
2016 ◽  
Vol 41 ◽  
pp. 56-61 ◽  
Author(s):  
Ravindra Arya ◽  
James L. Leach ◽  
Paul S. Horn ◽  
Hansel M. Greiner ◽  
Michael Gelfand ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Drug Resistant ◽  
Clinical Factors ◽  
Pediatric Mri ◽  
Drug Resistant Epilepsy

scholarly journals Neural Fragility as an EEG Marker of the Seizure Onset Zone

2019 ◽  
Author(s):  
Adam Li ◽  
Chester Huynh ◽  
Zachary Fitzgerald ◽  
Iahn Cajigas ◽  
Damian Brusko ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Predictive Power ◽  
Biological Marker ◽  
Complete Removal ◽  
Drug Resistant ◽  
Success Rates ◽  
Seizure Onset ◽  
Intracranial Eeg ◽  
Seizure Onset Zone ◽  
Drug Resistant Epilepsy

AbstractOver 15 million epilepsy patients worldwide do not respond to drugs. Successful surgical treatment requires complete removal, or disconnection of the seizure onset zone (SOZ), brain region(s) where seizures originate. Unfortunately, surgical success rates vary between 30%-70% because no clinically validated biological marker of the SOZ exists. We develop and retrospectively validate a new EEG marker - neural fragility. We validate this new marker in a retrospective analysis of 91 patients by using neural fragility of the annotated SOZ as a metric to predict surgical outcomes. Fragility predicts 43/47 surgical failures with an overall prediction accuracy of 76%, compared to the accuracy of clinicians being 48% (successful outcomes). In failed outcomes, we identify fragile regions that were untreated. When compared to 20 EEG features proposed as SOZ markers, fragility outperformed in predictive power and interpretability suggesting neural fragility as an EEG fingerprint of the SOZ.One Sentence SummaryNeural fragility, an intracranial EEG biomarker for the seizure onset zone in drug-resistant epilepsy, predicts surgical outcomes with high accuracy.

Prognostic factors of drug-resistant epilepsy in childhood: An Italian study

2015 ◽  
Vol 57 (6) ◽  
pp. 1143-1148
Author(s):  
Angelo Russo ◽  
Annio Posar ◽  
Sara Conti ◽  
Antonia Parmeggiani
Keyword(s):  
Prognostic Factors ◽  
Drug Resistant ◽  
Italian Study ◽  
Drug Resistant Epilepsy

scholarly journals Categorizing cortical dysplasia lesions for surgical outcome using network functional connectivity

2021 ◽  
pp. 1-9
Author(s):  
Abdullah S. Bdaiwi ◽  
Hansel M. Greiner ◽  
James Leach ◽  
Francesco T. Mangano ◽  
Mark W. DiFrancesco
Keyword(s):  
Functional Connectivity ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Network Connectivity ◽  
Cortical Dysplasia ◽  
Lesion Volume ◽  
Healthy Children ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
The Impact

OBJECTIVE Focal cortical dysplasia (FCD) is often associated with drug-resistant epilepsy, leading to a recommendation to surgically remove the seizure focus. Predicting outcome for resection of FCD is challenging, requiring a new approach. Lesion-symptom mapping is a powerful and broadly applicable method for linking neurological symptoms or outcomes to damage to particular brain regions. In this work, the authors applied lesion network mapping, an expansion of the traditional approach, to search for the association of lesion network connectivity with surgical outcomes. They hypothesized that connectivity of lesion volumes, preoperatively identified by MRI, would associate with seizure outcomes after surgery in a pediatric cohort with FCD. METHODS This retrospective study included 21 patients spanning the ages of 3 months to 17.7 years with FCD lesions who underwent surgery for drug-resistant epilepsy. The mean brain-wide functional connectivity map of each lesion volume was assessed across a database of resting-state functional MRI data from healthy children (spanning approximately 2.9 to 18.9 years old) compiled at the authors’ institution. Lesion connectivity maps were averaged across age and sex groupings from the database and matched to each patient. The authors sought to associate voxel-wise differences in these maps with subject-specific surgical outcome (seizure free vs persistent seizures). RESULTS Lesion volumes with persistent seizures after surgery tended to have stronger connectivity to attention and motor networks and weaker connectivity to the default mode network compared with lesion volumes with seizure-free surgical outcome. CONCLUSIONS Network connectivity–based lesion-outcome mapping may offer new insight for determining the impact of lesion volumes discerned according to both size and specific location. The results of this pilot study could be validated with a larger set of data, with the ultimate goal of allowing examination of lesions in patients with FCD and predicting their surgical outcomes.

scholarly journals Surgical outcome and prognostic factors in epilepsy patients with MR-negative focal cortical dysplasia

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249929
Author(s):  
Min Jae Seong ◽  
Su Jung Choi ◽  
Eun Yeon Joo ◽  
Young-Min Shon ◽  
Dae-Won Seo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Outcomes ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Type I ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Neuroimaging Data ◽  
Magnetic Resonance Imaging Mri ◽  
Drug Resistant Epilepsy

Objective Focal cortical dysplasia (FCD) represents a heterogeneous group of disorders of the cortical formation and is one of the most common causes of epilepsy. Magnetic resonance imaging (MRI) is the modality of choice for detecting structural lesions, and the surgical prognosis in patients with MR lesions is favorable. However, the surgical prognosis of patients with MR-negative FCD is unknown. We aimed to evaluate the long-term surgical outcomes and prognostic factors in MR-negative FCD patients through comprehensive presurgical data. Methods We retrospectively reviewed data from 719 drug-resistant epilepsy patients who underwent resective surgery and selected cases in which surgical specimens were pathologically confirmed as FCD Type I or II. If the epileptogenic focus and surgical specimens were obtained from brain areas with a normal MRI appearance, they were classified as MR-negative FCD. Surgical outcomes were evaluated at 2 and 5 years, and clinical, neurophysiological, and neuroimaging data of MR-negative FCD were compared to those of MR-positive FCD. Results Finally, 47 MR-negative and 34 MR-positive FCD patients were enrolled in the study. The seizure-free rate after surgery (Engel classification I) at postoperative 2 year was 59.5% and 64.7% in the MR-negative and positive FCD groups, respectively (p = 0.81). This rate decreased to 57.5% and 44.4% in the MR-negative and positive FCD groups (p = 0.43) at postoperative 5 years. MR-negative FCD showed a higher proportion of FCD type I (87.2% vs. 50.0%, p = 0.001) than MR-positive FCD. Unilobar cerebral perfusion distribution (odds ratio, OR 5.41) and concordance of interictal epileptiform discharges (OR 5.10) were significantly associated with good surgical outcomes in MR-negative FCD. Conclusion In this study, MR-negative and positive FCD patients had a comparable surgical prognosis, suggesting that comprehensive presurgical evaluations, including multimodal neuroimaging studies, are crucial for obtaining excellent surgical outcomes even in epilepsy patients with MR-negative FCD.

A RARE CASE OF DRUG-RESISTANT EPILEPSY ASSOCIATED WITH CORTICAL MICRODYSGENESIS

2018 ◽  
Vol 26 (2) ◽  
pp. 13-18
Author(s):  
Yu.M. Zabrodskaya ◽  
◽  
D.A. Sitovskaya ◽  
S.M. Malyshev ◽  
T.V. Sokolova ◽  
...  
Keyword(s):  
Rare Case ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy
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