• J. Neurol. Neurosurg. Psychiatr. · Oct 2020

    Electrical stimulation for seizure induction during SEEG exploration: a useful predictor of postoperative seizure recurrence?

    • Agnes Trebuchon, Renata Racila, Francesco Cardinale, Stanislas Lagarde, Aileen McGonigal, Lo RussoGiorgioGEpilepsy and Parkinson Surgery Centre "C. Munari", Ospedale Niguarda Ca' Granda, Milan, Italy., Didier Scavarda, Romain Carron, Roberto Mai, Patrick Chauvel, Fabrice Bartolomei, and Stefano Francione.
    • Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France agnes.trebuchon@univ-amu.fr.
    • J. Neurol. Neurosurg. Psychiatr. 2020 Oct 28.

    ObjectiveDirect electrical stimulations of cerebral cortex are a traditional part of stereoelectroencephalography (SEEG) practice, but their value as a predictive factor for seizure outcome has never been carefully investigated.Patients And MethodWe retrospectively analysed a cohort of 346 patients operated on for drug-resistant focal epilepsy after SEEG exploration. As potential predictors we included: aetiology, MRI data, age of onset, duration of epilepsy, age at surgery, topography of surgery and whether a seizure was induced by either low frequency electrical stimulation (LFS) or high frequency electrical stimulation.ResultsOf 346 patients, 63.6% had good outcome (no seizure recurrence, Engel I). Univariate analysis demonstrated significant correlation with favourable outcome (Engel I) for: aetiology, positive MRI and seizure induced by stimulation. At multivariate analysis, informative MRI, type II focal cortical dysplasia and tumour reduced the risk of seizure recurrence (SR) by 47%, 58% and 81%, respectively. Compared with the absence of induced seizures, the occurrence of ictal events after LFS significantly predicts a favourable outcome on seizures, with only 44% chance of disabling SR at last follow-up.ConclusionAmong the already known predictors outcome, seizure induction by LFS therefore represents a positive predictive factor for seizure outcome after surgery.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…