Cambios estructurales cerebrales en epilepsia generalizada idiopática identificados por análisis de imágenes de resonancia magnética automatizados.

Cerebral structural changes in generalized idiopathic epilepsy identified by automated magnetic resonance imaging analysis. The purpose of this study was to combine two automated methods of magnetic resonance imaging (MRI) structural analysis in order to identify structural changes in patients born in Argentina with idiopathic generalized epilepsy (IGE) compared to a healthy adult control group. Twenty-eight patients with IGE and 26 controls with no significant demographic differences were included. The analysis ofthe brain structures was conducted with two automated methods of magnetic resonance image analysis: voxelbased morphometry and FSL-integrated registration and segmentation toolbox (FSL-FIRST). FSL showed volume decrease in both thalamus in patients with IGE compared to the control group (left: 8092 mm3 control group vs. 7424 mm3 IGE, p = 0.0015; right: 7951 mm3 control group vs. 7247 mm3 IGE, p = 0.0016). A reduction in thevolume of both caudate nuclei was also seen (left: 3612 mm3 control group vs. 3376 mm3 IGE, p = 0.01; right: 3683 mm3 control group vs. 3459 mm3 IGE, p = 0.04). Voxel-based-morphometry showed a volume decrease in both caudate nuclei in patients with IGE compared to the control group. The other cerebral structures analyzed did not show significant differences between the groups. In conclusion, this study shows the reduction in volume in the subcortical, thalamic, and caudate nuclei structures in patients with IGE in comparison to control group.This study conducted in our country delves into the analysis of brain structural changes in patients with EGI compared to healthy subjects.Fil: Avalos, Juan Carlos. Hospital Italiano; ArgentinaFil: Sánchez, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Hospital Italiano; ArgentinaFil: Rosso, Barbara. Hospital Italiano; ArgentinaFil: Besocke, Ana Gabriela. Hospital Italiano; ArgentinaFil: García, María del Carmen. Hospital Italiano; Argentin

Surgical treatment of focal symptomatic refractory status epilepticus with and without invasive EEG

Purpose: Neurosurgery appears to be a reasonable alternative in carefully selected patients with refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). We discuss the optimal timing of the surgery and the use of previous stereoelectroencephalography (SEEG) invasive evaluation. Methods: We identified 3 patients (two pediatric and one adult) who underwent epilepsy surgery because of RSE or SRSE from our epilepsy surgery database, one of them with previous SEEG. Results: Status epilepticus resolved acutely in all of them with no mortality and no substantial morbidity. At follow-up (median: 2 years), 1 patient was seizure-free, and 2 had significant improvement. Conclusion: Surgery should be considered in all cases of RSE and SRSE early in the course of the evolution of the disease