Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Verentzioti Anastasia
Dissertation committee:
Γκατζώνης Στυλιανός: Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σακάς Ε. Δαμιανός: Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κιμισκίδης Βασίλειος: Καθηγητής, Ιατρική Σχολή, ΑΠΘ
Μητσικώστας Δήμος Δημήτριος: Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κυρώζης Ανδρέας: Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μπονάκης Αναστάσιος: Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κορφιάς Στέφανος: Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η σημασία και η χρησιμότητα της μακράς διάρκειας βίντεο ηλεκτροεγκεφαλογραφικής καταγραφής με ενδοκράνια ηλεκτρόδια σε ασθενείς με φαρμακοανθεκτική επιληψία υποψήφιους για χειρουργική θεραπεία
Translated title:
Importance and utility of long term video EEG monitoring with intracranial electrodes in drug resistant epileptic patients, who are candidates for surgery.
Summary:
INTRODUCTION: Despite the wide variety of antiepileptic drugs, 30% of the epileptic
patients suffer from drug resistant epilepsy. Epilepsy surgery attemps to fill this
theraupetic gap. Epilepsy surgery in Greece has evolved and established within the last
years.
PURPOSE: T and presentation of the post-surgical results of drug resistant epileptic
patients who are subject to intracranial electrodes placement, during their presurgical
evaluation.
The presentation of the protocol of epilepsy surgery applied in the Εpilepsy Unit of the
1st Department of Neurosurgery at Evangelismos hospital.
METHOD: 46 drug resistant epileptic patients were integrated to the study. They
presented for presurgical evaluation in the Epilepsy Unit during 2009-2018. Intracranial
electrodes were placed in all patients since they were not subject to standard surgical
approach. Post-surgical follow up was 1 to 6 years. Demographic data, MRI findings,
medication changes, complications and surgical outcome were recorded.
RESULTS: From 46 patients who were operated, data emerged from 49 surgical
resections and 48 surgical placements of intracranial electrodes. Mean duration of
epilepsy was 17,5 (±8,4) years. 43,5% of patients were operated with epilepsy of frontal
lobe, 32,6% of temporal lobe, 13% of parietal-occipital lobe and 10,9% of multi-lobar
epilepsy. Postsurgical seizure freedom was achieved in 47.8% of patients (Engel I
class), whereas 84,8% had significant seizures’ reduction. Complications occurred in
24.7% of surgical procedures, with 13% of patients presenting with permanent
neurological deficits (Hemianopia, hemiparesis, oscillopsia, mild optic scotoma). There
was no surgical mortality. Patients with presurgical MRI negative (1,5T) findings had ten
times more possibilities to present with unfavorable surgical outcome, comparing to
those with initial MRI positive findings. The ‘two stages’ surgical placement of
intracranial electrodes was applied in ambiguous or conflicted presurgical data.
CONCLUSION: The protocol of epilepsy surgery treatment elaborated within the
present study, demonstrates safety and efficacy to the majority of drug resistant
patients.
12
Years of epilepsy duration, sex, age, number of medications taken pre surgically do not
correlate with post surgical seizure outcome.
There is positive correlation between MRI negative presurgical findings and poor
seizure outcome.
Main subject category:
Health Sciences
Keywords:
Drug resistant epilepsy, Epilepsy surgery, Intracranial electrodes
Number of references:
577
