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Surgical treatment patients with drug-resistant unilateral MR-positive temporal forms of epilepsy
EANS Academy. Trifonov I. 09/25/19; 275289; EP07032
Dr. Igor Trifonov
Dr. Igor Trifonov

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Abstract
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Purpose: to evaluate the results of surgical treatment of patients with unilateral MR-positive temporal forms of drug-resistant epilepsy.
Method: prospective analysis of 50 patients with unilateral MR-positive temporal forms of drug-resistant epilepsy, who had undergone resective surgery in the Scientific Research Institute of Emergency Medicine of N.V. Sklifosovsky (Moscow) and in University Clinic of Moscow State University of Medicine and Dentistry between 01.01.2014 and 12.12.2017,were followed for 12 months after surgery. The average age at surgery was 32,3 years. The average duration of the disease - 18 years.
Results: In MRI all patients had MRI positive epileptogenic lesion. For all patients were made scalp EEG monitoring with seizures registration. When the results of MRI and scalp EEG were not concordance we made invasive video EEG. iEEG were made in 11 (22%) patients. All patients had anteriomedial temporal resections (AMTLE). 33 patients (66%) during AMTLE had 45 mm resection and 17 patients - 60 mm. There was no surgical mortality. In 38 patients (76%) hemianopia was noted Data of the pathohistology results were: FCD Ia - 1 patients, FCD Ic - 2, FCD IIa - 6, FCD IIb - 1, FCD IIIa - 29, FCD IIIb - 1, FCD IIIc - 2, FCD IIId - 4, DNET - 1, LGG - 3. Outcomes of 50 patients (92%) were evaluated 12 months after surgery: 41 patients (82%) became seizure free: 35 patients (70%) - Engel Ia, 3 patients (6%) - Engel Ib, 3 (6%) - Engel Ic. Five patients (10%) had - Engel IIa, 2 (4%) - Engel IIb, one - Engel IId. The unsatisfactory result of treatment was noted at one patient (2%) -Engel IVa.
Conclusion: the provided results confirm efficiency and safety of surgical treatment drug-resistant epilepsy. 82 % patients become «seizure free» 12 months after surgical treatment.
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