Electroclinical features and surgical outcomes in cingulate epilepsy - A single- centre experience
Kiren George Koshy1, Adarsh Anil Kumar2, Bejoy Thomas2
1Department of Neurology, R Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, India.
Clinical Neurology and Neurosurgery
|April 29, 2026
Summary
Cingulate epilepsy surgery offers favorable outcomes, with 72% achieving seizure freedom. This study highlights the importance of advanced imaging and multidisciplinary evaluation for successful management of this challenging epilepsy type.
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- Cingulate epilepsy can present with symptoms mimicking other epilepsy types.
- Accurate diagnosis and surgical planning are crucial for effective treatment.
Purpose of the Study:
- To characterize clinical, electrophysiological, and imaging features of cingulate epilepsy.
- To evaluate surgical outcomes following resection for cingulate epilepsy at a South Indian tertiary center.
Main Methods:
- Retrospective analysis of 25 patients undergoing cingulate cortex lesionectomy (1995-2023).
- Inclusion of lesions extending to adjacent areas (cingulate plus).
- Analysis of clinical data, semiology, EEG, MRI, histopathology, and surgical outcomes (Engel classification).
Main Results:
- Hypermotor seizures (56%) and focal dyscognitive seizures (28%) were most common.
- MRI detected lesions in 96%, predominantly focal cortical dysplasia.
- 72% of patients achieved Engel class I outcome at last follow-up (mean 2.6 years).
Conclusions:
- Cingulate epilepsy has diverse, non-specific semiology; scalp EEG often lacks localization.
- Favorable surgical outcomes are achievable, particularly in lesional cases.
- High-resolution imaging and multidisciplinary evaluation are key for successful cingulate epilepsy surgery.
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