Evaluación del tratamiento quirúrgico temprano en lactantes con epilepsias catastróficas asociadas a displasias corticales

Translated title of the contribution: Evaluation of early surgical treatment in infants with catastrophic epilepsies associated with cortical dysplasias

Andrea Andrade-Bañuelos, Guadalupe Jean-Tron, Fabiola Estela Ortega-Ponce, S. T. Arnold, R. Said, A. Price, Mauricio Cortina-Ramírez

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Cortical dysplasias (CD) can present as catastrophic epilepsy in early infancy, which may have a negative impact in neurological development. The interictal electroencephalogram (EEG), usually shows diffuse or generalized abnormalities that can complicate surgical decisions. Objective: The aim of the study was to describe the EEG findings and surgical outcome of infants with symptomatic catastrophic epilepsy associated with cortical dysplasia. Methods: We retrospectively reviewed EEGs and electronic charts of patients who had diagnosis of cortical dysplasia and underwent epilepsy surgery before the age of 3 years, from 2005 to 2010 in the clinical database of the Epilepsy Comprehensive Center, Children's Medical Center, Dallas, Texas. Results: We found 4/7 girls and 3 /7 boys. The seizure onset was from 0 to 22 months (mean 18 months). The seizure frequency was from 13 to 50 a day (mean 28). We reviewed 24 interictal EEGs, 9/24 showed generalized activity (37.5%) and 15/24 (62%) were focal. We reviewed 9 ictal vEEGs 7/9 were concordant with the lesion (77.7%). The 7 patients underwent intraoperative electrocorticography (ECoG). In 2/7 (28%) chronic invasive monitoring was required. 3/7 (42%) had seizure recurrence, requiring functional hemispherotomy. 6/7 (87%) are currently seizure free, and 1/7 had a 90% seizure reduction. Postsurgically, all patients showed improvement on neurological development. Conclusions: The EEG patterns in infants with catastrophic epilepsy whose epileptogenic focus is associated with cortical dysplasia can be misleading and show generalized epileptiform activity. An early and extensive presurgical evaluation is necessary for a successful surgery associated with a positive neurological development and seizure control outcomes.

Original languageSpanish
Pages (from-to)132-138
Number of pages7
JournalRevista Mexicana de Neurociencia
Volume13
Issue number3
StatePublished - May 2012

Fingerprint

Malformations of Cortical Development
Epilepsy
Seizures
Electroencephalography
Therapeutics
Stroke
Databases
Recurrence

Keywords

  • Catastrophic epilepsy, cortical dysplasia
  • Early epilepsy surgery
  • Infants

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Public Health, Environmental and Occupational Health
  • Neuropsychology and Physiological Psychology

Cite this

Evaluación del tratamiento quirúrgico temprano en lactantes con epilepsias catastróficas asociadas a displasias corticales. / Andrade-Bañuelos, Andrea; Jean-Tron, Guadalupe; Ortega-Ponce, Fabiola Estela; Arnold, S. T.; Said, R.; Price, A.; Cortina-Ramírez, Mauricio.

In: Revista Mexicana de Neurociencia, Vol. 13, No. 3, 05.2012, p. 132-138.

Research output: Contribution to journalArticle

Andrade-Bañuelos, A, Jean-Tron, G, Ortega-Ponce, FE, Arnold, ST, Said, R, Price, A & Cortina-Ramírez, M 2012, 'Evaluación del tratamiento quirúrgico temprano en lactantes con epilepsias catastróficas asociadas a displasias corticales', Revista Mexicana de Neurociencia, vol. 13, no. 3, pp. 132-138.
Andrade-Bañuelos, Andrea ; Jean-Tron, Guadalupe ; Ortega-Ponce, Fabiola Estela ; Arnold, S. T. ; Said, R. ; Price, A. ; Cortina-Ramírez, Mauricio. / Evaluación del tratamiento quirúrgico temprano en lactantes con epilepsias catastróficas asociadas a displasias corticales. In: Revista Mexicana de Neurociencia. 2012 ; Vol. 13, No. 3. pp. 132-138.
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abstract = "Introduction: Cortical dysplasias (CD) can present as catastrophic epilepsy in early infancy, which may have a negative impact in neurological development. The interictal electroencephalogram (EEG), usually shows diffuse or generalized abnormalities that can complicate surgical decisions. Objective: The aim of the study was to describe the EEG findings and surgical outcome of infants with symptomatic catastrophic epilepsy associated with cortical dysplasia. Methods: We retrospectively reviewed EEGs and electronic charts of patients who had diagnosis of cortical dysplasia and underwent epilepsy surgery before the age of 3 years, from 2005 to 2010 in the clinical database of the Epilepsy Comprehensive Center, Children's Medical Center, Dallas, Texas. Results: We found 4/7 girls and 3 /7 boys. The seizure onset was from 0 to 22 months (mean 18 months). The seizure frequency was from 13 to 50 a day (mean 28). We reviewed 24 interictal EEGs, 9/24 showed generalized activity (37.5{\%}) and 15/24 (62{\%}) were focal. We reviewed 9 ictal vEEGs 7/9 were concordant with the lesion (77.7{\%}). The 7 patients underwent intraoperative electrocorticography (ECoG). In 2/7 (28{\%}) chronic invasive monitoring was required. 3/7 (42{\%}) had seizure recurrence, requiring functional hemispherotomy. 6/7 (87{\%}) are currently seizure free, and 1/7 had a 90{\%} seizure reduction. Postsurgically, all patients showed improvement on neurological development. Conclusions: The EEG patterns in infants with catastrophic epilepsy whose epileptogenic focus is associated with cortical dysplasia can be misleading and show generalized epileptiform activity. An early and extensive presurgical evaluation is necessary for a successful surgery associated with a positive neurological development and seizure control outcomes.",
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