El Tahry Riëm, Ferrao Santos Susana, de Tourtchaninoff Marianne, Géraldo Ribeiro Vaz José, Finet Patrice, Raftopoulos Christian, van Rijckevorsel Kenou
Department of Neurology, Center for Refractory Epilepsy, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av. Hippocrate 10, 1200, Brussels, Belgium.
Department of Neurosurgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av. Hippocrate 10, 1200, Brussels, Belgium.
Acta Neurol Belg. 2016 Sep;116(3):279-85. doi: 10.1007/s13760-016-0641-2. Epub 2016 Apr 19.
Intra-operative electrocorticography (ECoG) has been traditionally used in the surgical management of medically refractory partial epilepsies to identify the limits of the epileptogenic zone. This retrospective study had as goal to evaluate whether tailored surgery based on the presurgical evaluation completed by intra-operative post-resection ECoG improves outcome. We reviewed 94 cases of epilepsy surgery with intra-operative ECoG and determined how many had an ECoG-guided surgical procedure in addition to the initial planned surgery. We also reviewed the presence of specific recurrent ECoG patterns of interictal epileptiform discharges (IED) in the exposed cortical surface, such as: electrographic seizures, bursts, intermittent spike waves, polyspikes or fast rhythms and continuous or quasi-continuous spiking. When performing a post-resection ECoG-tailored surgery, outcome did not improve in lesional or non-lesional epilepsy. Postoperative residual IED did not correlate with a poorer outcome. In our study, the persistence of post-resection IED on ECoG is not correlated with outcome in patients with lesional or non-lesional epilepsy.
术中皮质脑电图（ECoG）传统上用于药物难治性部分性癫痫的手术治疗，以确定致痫区的范围。这项回顾性研究旨在评估基于术中切除后ECoG完成的术前评估进行的定制手术是否能改善预后。我们回顾了94例接受术中ECoG的癫痫手术病例，并确定除了最初计划的手术外，有多少例进行了ECoG引导的手术。我们还回顾了暴露皮质表面间歇性癫痫样放电（IED）的特定复发性ECoG模式的存在情况，例如：脑电图发作、爆发、间歇性棘波、多棘波或快速节律以及连续或准连续棘波。在进行切除后ECoG定制手术时，病灶性或非病灶性癫痫的预后并未改善。术后残留的IED与较差的预后无关。在我们的研究中，病灶性或非病灶性癫痫患者切除后ECoG上IED的持续存在与预后无关。
