Electrocorticographic Patterns in Epilepsy Surgery and Long-Term Outcome.
Daniel San-Juan1, Mario Arturo Alonso-Vanegas, Carlos Trenado
1Departments of *Clinical Neurophysiology and †Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; ‡Centre for Movement Disorders and Neuromodulation Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Düsseldorf, Germany; §Department Clinical Neurophysiology, "November 20" Medical Center, Institute for Social Security and Services for State Workers, Mexico City, Mexico; ‖Medicine Academic Unit, Autonomous University of Nayarit, Tepic, Mexico; and ¶Clinical Research Department, Superior School of Medicine, National Polytechnic Institute, Mexico City, Mexico.
Intraoperative electrocorticography patterns and epilepsy etiology significantly impact surgical outcomes. Understanding these factors is crucial for improving epilepsy surgery success rates.
Area of Science:
- Neurosurgery
- Epileptology
- Neurophysiology
Background:
- Intraoperative electrocorticography (iECoG) plays a role in epilepsy surgery, but its patterns and impact on outcomes remain debated.
- Previous studies have yielded contradictory results regarding the efficacy of iECoG in predicting surgical success.
Purpose of the Study:
- To describe intraoperative electrocorticography (iECoG) patterns observed during epilepsy surgery.
- To investigate the association between these iECoG patterns, epilepsy etiology, and surgical outcomes.
Main Methods:
- Retrospective analysis of 104 patients undergoing epilepsy surgery between 2009 and 2015.
- Classification of pre-resection iECoG patterns (sporadic, continuous, burst, recruiting interictal epileptiform discharges-IEDs) and post-resection iECoG outcomes (de novo, residual, without IEDs).
- Evaluation of outcomes using the Engel scale and statistical analysis including ANOVA.
Main Results:
- The most common pre-resection iECoG pattern was sporadic IEDs (47%).
- Post-resection, de novo patterns were most frequent (55.7%), followed by residual (27.8%) and without IEDs (16.3%).
- Significant differences in outcomes were observed based on epilepsy etiology (P=0.021) and pre-resection iECoG patterns (P=0.008).
Conclusions:
- Pre-resection iECoG patterns are a significant factor influencing the Engel scale outcome in epilepsy surgery.
- Epilepsy etiology also plays a crucial role in determining surgical success in lesional epilepsy surgery.
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