Tailored cortical resection following image guided subdural grid implantation for medically refractory epilepsy.

Abstract

The aim of this study was to report the safety and efficacy of tailored cortical resection based on image guided subdural electrode implantations in eight patients with medically refractory epilepsy. The patients were selected for multimodality image guided subdural grid implantation, inpatient invasive electroencephalography video monitoring and surgical resection of epileptogenic foci. All patients had frequent disabling, medically refractory seizures pre-operatively. At a minimum of 10 months post-resection all patients had a worthwhile improvement in seizure frequency, with 7 of the 8 (87.5%) having an excellent outcome (Engel Class I). Short-term complications of grid implantation were: one patient with a post-operative subdural haemorrhage and one patient with a transient fluctuating dysphasia. The only long-term complication was a mild, non-disabling dysarthria following resection near eloquent speech cortex in one patient. We conclude that tailored cortical resection following image-guided insertion of subdural grids is a reliable, safe and highly effective method for the treatment of medically refractory epilepsy in carefully selected patients.

• Authors: Simon V Liubinas, Denis Cassidy, Annie Roten, Andrew H Kaye, Terence J O'Brien
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 16 Issue 11 Pg. 1398-408 (Nov 2009) ISSN: 1532-2653 [Electronic] Scotland
• PMID: 19683926 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cerebral Cortex (surgery)
• Diagnostic Imaging (methods)
• Electrodes, Implanted
• Epilepsy (diagnostic imaging, pathology, surgery)
• Female
• Humans
• Male
• Middle Aged
• Neurosurgical Procedures (adverse effects, instrumentation, methods)
• Radionuclide Imaging
• Subdural Space (surgery)
• Treatment Outcome
• Young Adult