Surgical Treatment in Refractory Epilepsy: Seizure Outcome Results Based on Invasive EEG Monitorization

Area of Science:

• Neurology
• Neurosurgery
• Epileptology

Background:

• Refractory epilepsy necessitates advanced diagnostic tools for surgical planning.
• Invasive electroencephalography (EEG) monitoring (IEM) plays a key role in localizing the epileptogenic zone.
• Understanding factors influencing surgical outcomes is vital for patient management.

Purpose of the Study:

• To evaluate seizure outcomes in patients undergoing epilepsy surgery after invasive EEG monitoring (IEM).
• To identify factors associated with favorable seizure outcomes following epilepsy surgery.
• To underscore the importance of IEM in surgical decision-making for refractory epilepsy.

Main Methods:

• Retrospective analysis of 47 patients with refractory epilepsy evaluated by invasive EEG.
• Review of video EEG, invasive EEG monitoring, MRI, SPECT, PET, and neuropsychological tests.
• Postoperative seizure outcomes classified using the Engel classification system.

Main Results:

• 81.6% of patients achieved favorable seizure outcomes (Engel Class I) post-surgery.
• Hippocampal sclerosis (HS) was the most frequent etiology (38.3%).
• A significant correlation was found between structural MRI lesions and favorable seizure outcomes (p < 0.05).

Conclusions:

• Invasive EEG monitoring (IEM) is essential for determining the epileptogenic zone and improving surgical outcomes.
• Structural MRI lesions are significantly associated with favorable seizure control after epilepsy surgery.
• While age at surgery and onset were lower in Engel I patients, the difference was not statistically significant.