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Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
Published on: June 13, 2016
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Volumen prequirúrgico de la corteza entorrinal y resultado de las convulsiones postoperatorias en la epilepsia del
Samia Elkommos1, Mark P Richardson2, Jan-Christoph Schoene-Bake3
1Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Lancet (London, England)
|August 28, 2015
Resumen
El volumen reducido de la corteza entorrinal en pacientes con epilepsia del lóbulo temporal mesial intratable (mTLE) no predice el éxito quirúrgico. Se necesita más investigación para comprender los factores que influyen en los resultados de las convulsiones después de la cirugía de epilepsia.
Área de la Ciencia:
- Neurología
- Neurocirugía
- Investigación sobre la epilepsia
Sus antecedentes:
- La cirugía de epilepsia del lóbulo temporal mesial (mTLE) es efectiva pero falla en un tercio de los pacientes.
- Se supone que las anomalías en la corteza entorrinal causan la ERMT resistente a la cirugía.
- Investigando el volumen de la corteza entorrinal prequirúrgica como un predictor del resultado quirúrgico.
Objetivo del estudio:
- Determinar si el volumen de la corteza entorrinal antes de la cirugía predice el control de las convulsiones postoperatorias en pacientes con ERMT intratable.
- Para explorar la asociación entre el volumen de la corteza entorrinal y los resultados quirúrgicos.
Principales métodos:
- Se analizaron imágenes de resonancia magnética de 78 pacientes con LEMT intratable y 76 controles sanos.
- Se utilizaron técnicas manuales para medir los volúmenes de la corteza entorrinal izquierda y derecha.
- Los resultados postoperatorios se evaluaron utilizando la clasificación de la Liga Internacional contra la Epilepsia (ILAE).
Principales resultados:
- En comparación con el grupo de control, los pacientes con LESm mostraron volúmenes reducidos de corteza entorrinal ipsilateral.
- Los pacientes con mTLE derecho también presentaron reducción del volumen de la corteza entorrinal contralateral.
- No se encontraron diferencias significativas en los volúmenes de la corteza entorrinal entre los pacientes sin convulsiones y aquellos con convulsiones persistentes.
Conclusiones:
- La atrofia gruesa de la corteza entorrinal no predice resultados postoperatorios en el LEMT intratable.
- Se requiere una mayor investigación sobre la conectividad de la corteza entorrinal y la extensión de la resección.
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