Outcome of surgical treatment in non-lesional intractable childhood epilepsy

Joo Hee Seo, Byoung Ho Noh, Joon Soo Lee, Dong Suk Kim, Seung Koo Lee, Tae Seung Kim, SeHoon Kim, hoonchul kang, HeungDong Kim

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study is to investigate seizure outcomes following epilepsy surgery in non-lesional neocortical pediatric epilepsy. Methods: We performed a retrospective study on 27 patients with intractable childhood epilepsy who received epilepsy surgery between 1999 and 2006 at Sang-gye Paik Hospital and Severance Children's Hospital. None of the patients had any detectable lesions on MRI. Surgical outcome was assessed at least 2 years postoperatively; clinical characteristics, surgical outcome, pathologic findings, types of surgery, localizing features on SPECT, FDG-PET, and long-term video-EEG were reviewed. Results: Eighteen patients (67%) demonstrated an Engel class I outcome postoperatively. The mean follow-up duration was 4.3 years (range, 2.2-9 years). Eighteen out of 27 cases (67%) showed focal localizing features on ictal SPECT, and 21 of 27 cases (78%) showed abnormal findings on PET. Single lobectomy was the most common procedure, and was performed in 20 patients (74%). Multilobar resection was performed in seven patients (26%). Cortical dysplasia was the most common finding during pathological examination, and was observed in 15 (56%) cases. In addition, gliosis was found in two patients (7%) and non-specific pathological findings were described in 10 patients (37%). Conclusions: In children with intractable epilepsy and a MRI demonstrating no abnormal lesions, epileptic surgery should be strongly considered when cortical pathology can be identified from other studies.

Original languageEnglish
Pages (from-to)625-629
Number of pages5
JournalSeizure
Volume18
Issue number9
DOIs
Publication statusPublished - 2009 Nov 1

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Epilepsy
Single-Photon Emission-Computed Tomography
Malformations of Cortical Development
Gliosis
Drug Resistant Epilepsy
Electroencephalography
Seizures
Retrospective Studies
Stroke
Pediatrics
Pathology

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Seo, J. H., Noh, B. H., Lee, J. S., Kim, D. S., Lee, S. K., Kim, T. S., ... Kim, H. (2009). Outcome of surgical treatment in non-lesional intractable childhood epilepsy. Seizure, 18(9), 625-629. https://doi.org/10.1016/j.seizure.2009.07.007
Seo, Joo Hee ; Noh, Byoung Ho ; Lee, Joon Soo ; Kim, Dong Suk ; Lee, Seung Koo ; Kim, Tae Seung ; Kim, SeHoon ; kang, hoonchul ; Kim, HeungDong. / Outcome of surgical treatment in non-lesional intractable childhood epilepsy. In: Seizure. 2009 ; Vol. 18, No. 9. pp. 625-629.
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abstract = "Purpose: The aim of this study is to investigate seizure outcomes following epilepsy surgery in non-lesional neocortical pediatric epilepsy. Methods: We performed a retrospective study on 27 patients with intractable childhood epilepsy who received epilepsy surgery between 1999 and 2006 at Sang-gye Paik Hospital and Severance Children's Hospital. None of the patients had any detectable lesions on MRI. Surgical outcome was assessed at least 2 years postoperatively; clinical characteristics, surgical outcome, pathologic findings, types of surgery, localizing features on SPECT, FDG-PET, and long-term video-EEG were reviewed. Results: Eighteen patients (67{\%}) demonstrated an Engel class I outcome postoperatively. The mean follow-up duration was 4.3 years (range, 2.2-9 years). Eighteen out of 27 cases (67{\%}) showed focal localizing features on ictal SPECT, and 21 of 27 cases (78{\%}) showed abnormal findings on PET. Single lobectomy was the most common procedure, and was performed in 20 patients (74{\%}). Multilobar resection was performed in seven patients (26{\%}). Cortical dysplasia was the most common finding during pathological examination, and was observed in 15 (56{\%}) cases. In addition, gliosis was found in two patients (7{\%}) and non-specific pathological findings were described in 10 patients (37{\%}). Conclusions: In children with intractable epilepsy and a MRI demonstrating no abnormal lesions, epileptic surgery should be strongly considered when cortical pathology can be identified from other studies.",
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Outcome of surgical treatment in non-lesional intractable childhood epilepsy. / Seo, Joo Hee; Noh, Byoung Ho; Lee, Joon Soo; Kim, Dong Suk; Lee, Seung Koo; Kim, Tae Seung; Kim, SeHoon; kang, hoonchul; Kim, HeungDong.

In: Seizure, Vol. 18, No. 9, 01.11.2009, p. 625-629.

Research output: Contribution to journalArticle

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T1 - Outcome of surgical treatment in non-lesional intractable childhood epilepsy

AU - Seo, Joo Hee

AU - Noh, Byoung Ho

AU - Lee, Joon Soo

AU - Kim, Dong Suk

AU - Lee, Seung Koo

AU - Kim, Tae Seung

AU - Kim, SeHoon

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AU - Kim, HeungDong

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N2 - Purpose: The aim of this study is to investigate seizure outcomes following epilepsy surgery in non-lesional neocortical pediatric epilepsy. Methods: We performed a retrospective study on 27 patients with intractable childhood epilepsy who received epilepsy surgery between 1999 and 2006 at Sang-gye Paik Hospital and Severance Children's Hospital. None of the patients had any detectable lesions on MRI. Surgical outcome was assessed at least 2 years postoperatively; clinical characteristics, surgical outcome, pathologic findings, types of surgery, localizing features on SPECT, FDG-PET, and long-term video-EEG were reviewed. Results: Eighteen patients (67%) demonstrated an Engel class I outcome postoperatively. The mean follow-up duration was 4.3 years (range, 2.2-9 years). Eighteen out of 27 cases (67%) showed focal localizing features on ictal SPECT, and 21 of 27 cases (78%) showed abnormal findings on PET. Single lobectomy was the most common procedure, and was performed in 20 patients (74%). Multilobar resection was performed in seven patients (26%). Cortical dysplasia was the most common finding during pathological examination, and was observed in 15 (56%) cases. In addition, gliosis was found in two patients (7%) and non-specific pathological findings were described in 10 patients (37%). Conclusions: In children with intractable epilepsy and a MRI demonstrating no abnormal lesions, epileptic surgery should be strongly considered when cortical pathology can be identified from other studies.

AB - Purpose: The aim of this study is to investigate seizure outcomes following epilepsy surgery in non-lesional neocortical pediatric epilepsy. Methods: We performed a retrospective study on 27 patients with intractable childhood epilepsy who received epilepsy surgery between 1999 and 2006 at Sang-gye Paik Hospital and Severance Children's Hospital. None of the patients had any detectable lesions on MRI. Surgical outcome was assessed at least 2 years postoperatively; clinical characteristics, surgical outcome, pathologic findings, types of surgery, localizing features on SPECT, FDG-PET, and long-term video-EEG were reviewed. Results: Eighteen patients (67%) demonstrated an Engel class I outcome postoperatively. The mean follow-up duration was 4.3 years (range, 2.2-9 years). Eighteen out of 27 cases (67%) showed focal localizing features on ictal SPECT, and 21 of 27 cases (78%) showed abnormal findings on PET. Single lobectomy was the most common procedure, and was performed in 20 patients (74%). Multilobar resection was performed in seven patients (26%). Cortical dysplasia was the most common finding during pathological examination, and was observed in 15 (56%) cases. In addition, gliosis was found in two patients (7%) and non-specific pathological findings were described in 10 patients (37%). Conclusions: In children with intractable epilepsy and a MRI demonstrating no abnormal lesions, epileptic surgery should be strongly considered when cortical pathology can be identified from other studies.

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