Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography

Morales Chacón, Lilia María; González González, Judith; Ríos Castillo, Martha; Berrillo Batista, Sheila; Batista García-Ramo, Karla; Santos Santos, Aisel; Quintanal Cordero, Nelson; Zaldívar Bermúdez, Marilyn; Garbey Fernández, Randis; Estupiñan Díaz, Bárbara; Hernández Díaz, Zenaida; Bender del Busto, Juan E.; Sánchez Coroneux, Abel; Báez Martin, Margarita M.; Lorigados Pedre, Lourdes

doi:10.3390/bs11030030

Open AccessArticle

Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography

by

Lilia María Morales Chacón

^*,

Judith González González

,

Martha Ríos Castillo

,

Sheila Berrillo Batista

,

Karla Batista García-Ramo

,

Aisel Santos Santos

,

Nelson Quintanal Cordero

,

Marilyn Zaldívar Bermúdez

,

Randis Garbey Fernández

,

Bárbara Estupiñan Díaz

,

Zenaida Hernández Díaz

,

Juan E. Bender del Busto

,

Abel Sánchez Coroneux

,

Margarita M. Báez Martin

and

Lourdes Lorigados Pedre

International Center for Neurological Restoration, National Epilepsy Surgery Program, 25th Ave, No 15805, Havana PC 11300, Cuba

^*

Author to whom correspondence should be addressed.

Behav. Sci. 2021, 11(3), 30; https://doi.org/10.3390/bs11030030

Submission received: 25 December 2020 / Revised: 18 February 2021 / Accepted: 19 February 2021 / Published: 4 March 2021

(This article belongs to the Special Issue Behavioral Disorders, Coronavirus and the Nervous System)

Download

Browse Figures

Versions Notes

Abstract

Objective: to present the postsurgical outcome of extratemporal epilepsy (ExTLE) patients submitted to preoperative multimodal evaluation and intraoperative sequential electrocorticography (ECoG). Subjects and methods: thirty-four pharmaco-resistant patients with lesional and non-lesional ExTLE underwent comprehensive pre-surgical evaluation including multimodal neuroimaging such as ictal and interictal perfusion single photon emission computed tomography (SPECT) scans, subtraction of ictal and interictal SPECT co-registered with magnetic resonance imaging (SISCOM) and electroencephalography (EEG) source imaging (ESI) of ictal epileptic activity. Surgical procedures were tailored by sequential intraoperative ECoG, and absolute spike frequency (ASF) was calculated in the pre- and post-resection ECoG. Postoperative clinical outcome assessment for each patient was carried out one year after surgery using Engel scores. Results: frontal and occipital resection were the most common surgical techniques applied. In addition, surgical resection encroaching upon eloquent cortex was accomplished in 41% of the ExTLE patients. Pre-surgical magnetic resonance imaging (MRI) did not indicate a distinct lesion in 47% of the cases. In the latter number of subjects, SISCOM and ESI of ictal epileptic activity made it possible to estimate the epileptogenic zone. After one- year follow up, 55.8% of the patients was categorized as Engel class I–II. In this study, there was no difference in the clinical outcome between lesional and non lesional ExTLE patients. About 43.7% of patients without lesion were also seizure- free, p = 0.15 (Fischer exact test). Patients with satisfactory seizure outcome showed lower absolute spike frequency in the pre-resection intraoperative ECoG than those with unsatisfactory seizure outcome, (Mann– Whitney U test, p = 0.005). Conclusions: this study has shown that multimodal pre-surgical evaluation based, particularly, on data from SISCOM and ESI alongside sequential intraoperative ECoG, allow seizure control to be achieved in patients with pharmacoresistant ExTLE epilepsy.

Keywords: extratemporal epilepsy surgery; multimodal neuroimaging; intraoperative electrocorticography; seizure outcome

Share and Cite

MDPI and ACS Style

Morales Chacón, L.M.; González González, J.; Ríos Castillo, M.; Berrillo Batista, S.; Batista García-Ramo, K.; Santos Santos, A.; Quintanal Cordero, N.; Zaldívar Bermúdez, M.; Garbey Fernández, R.; Estupiñan Díaz, B.; et al. Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography. Behav. Sci. 2021, 11, 30. https://doi.org/10.3390/bs11030030

AMA Style

Morales Chacón LM, González González J, Ríos Castillo M, Berrillo Batista S, Batista García-Ramo K, Santos Santos A, Quintanal Cordero N, Zaldívar Bermúdez M, Garbey Fernández R, Estupiñan Díaz B, et al. Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography. Behavioral Sciences. 2021; 11(3):30. https://doi.org/10.3390/bs11030030

Chicago/Turabian Style

Morales Chacón, Lilia María, Judith González González, Martha Ríos Castillo, Sheila Berrillo Batista, Karla Batista García-Ramo, Aisel Santos Santos, Nelson Quintanal Cordero, Marilyn Zaldívar Bermúdez, Randis Garbey Fernández, Bárbara Estupiñan Díaz, and et al. 2021. "Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography" Behavioral Sciences 11, no. 3: 30. https://doi.org/10.3390/bs11030030

APA Style

Morales Chacón, L. M., González González, J., Ríos Castillo, M., Berrillo Batista, S., Batista García-Ramo, K., Santos Santos, A., Quintanal Cordero, N., Zaldívar Bermúdez, M., Garbey Fernández, R., Estupiñan Díaz, B., Hernández Díaz, Z., Bender del Busto, J. E., Sánchez Coroneux, A., Báez Martin, M. M., & Lorigados Pedre, L. (2021). Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography. Behavioral Sciences, 11(3), 30. https://doi.org/10.3390/bs11030030

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

Surgical Outcome in Extratemporal Epilepsies Based on Multimodal Pre-Surgical Evaluation and Sequential Intraoperative Electrocorticography

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI