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Absence seizures in lesion-related epilepsy
Xiaoqin Sun1, Miao Wang1, Zeng He1
1Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba District, Chongqing, 400037, China.
Acta Epileptologica
|April 11, 2025
Summary
Focal onset absence seizures (ASs) linked to structural lesions show positive surgical outcomes. Lesion resection in these epilepsy patients led to seizure freedom and improved intelligence quotient (IQ).
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- The International League Against Epilepsy (ILAE) classification acknowledges generalized seizures, like absence seizures (ASs), may stem from focal origins.
- Evidence suggests focal changes precede ASs, but the link between ASs and epileptogenic lesions is not fully understood.
Purpose of the Study:
- To investigate the relationship between absence seizures (ASs) and underlying structural lesions.
- To evaluate surgical outcomes in patients with ASs and focal lesions.
Main Methods:
- Retrospective analysis of clinical, imaging, and electrophysiological data from 16 patients with ASs and structural lesions.
- Assessment of seizure semiology, ictal and interictal electroencephalography (EEG), and stereoelectroencephalogram (SEEG).
- Evaluation of outcomes following lesion resection, including seizure freedom and cognitive function.
Main Results:
- Nine patients exhibited focal onset ASs; most (81.3%) had additional focal features.
- Structural lesions were identified in all patients, frequently in the posterior cortex (56%).
- All patients achieved seizure freedom post-lesion resection, with an average IQ improvement of 10.71 points one year after surgery.
Conclusions:
- Absence seizures (ASs) in lesion-related epilepsy can originate from a focal point.
- Surgical resection of structural lesions associated with ASs leads to favorable seizure control and cognitive enhancement.
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