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Surgery vs no surgery in MRI negative temporal drug resistant forms of epilepsy
EANS Academy. Trifonov I. 09/25/19; 275290; EP07037
Dr. Igor Trifonov
Dr. Igor Trifonov

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Abstract
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Purpose: to evaluate the effectiveness of anteromesial temporal resection (AMTR) versus no surgery on seizure-free outcome in patients with.
Method: We analyzed 22 patients (12 women and 10 men) who assigned treatment with antiepileptic drugs (AED) and 48 patients (26 women and 22 men) who underwent epilepsy surgery for one year with drug-resistant MRI-negative epilepsy. Patients with AED treatment were under medical supervision in Buyanov City Clinical Hospital (Moscow), patients in surgical group were operated in the University Clinic of Moscow State University of Medicine and Dentistry (Moscow). Patients were followed up at 12 months after surgery and AED treatment.
Results: In group of AED treatment the duration of the epilepsy was 24,68±11,79 years, in surgery group - 19,76±12,64 years. The patient's average year in AED group was - 39,09±11,09, in surgery group - 34,58±10,43 years. Intracranial video EEG recordings were made in 31 (64%) patients, average duration - 106 hours. 32 patients (66%) during AMTR had 45 mm resection and 16 patients - 60 mm. There was no surgical mortality. In 30 patients (62,5%) hemianopia was noted Data of the pathohistology results were: FCD Ia - 6 patients, FCD Ic - 16, FCD IIa - 6, FCD IIIa - 6, FCD IIIc - 1, FCD IIId - 12. At one year, the cumulative proportion of patients who were free of seizures was 45 percent in the surgical group and 8 percent in the medical group.
Conclusion: This is the first assessment of the results of the epilepsy surgery vs no surgery of patients with MRI-negative temporal forms of drug-resistant epilepsy in Russia. AMTR is effective and safety procedure in treatment of MRI-negative temporal drug-resistant forms epilepsy.
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