3 research outputs found
Surgical outcome in patients with MRI-negative, PET-positive temporal lobe epilepsy
AbstractPurposeThe purpose of this study was to determine the long-term surgical outcomes of magnetic resonance imaging (MRI)-negative, fluorodeoxyglucose positron emission tomography (FDG-PET)-positive patients with temporal lobe epilepsy (TLE) and compare them with those of patients with mesial temporal sclerosis (MTS).MethodsOne hundred forty-one patients with TLE who underwent anterior temporal lobectomy were included in the study. The surgical outcomes of 24 patients with unilateral temporal hypometabolism on FDG-PET without an epileptogenic lesion on MRI were compared with that of patients with unilateral temporal hypometabolism on FDG-PET with MTS on MRI (n=117). The outcomes were compared using Engel's classification at 2 years after surgery. Clinical characteristics, unilateral interictal epileptiform discharges (IEDs), histopathological data and operation side were considered as probable prognostic factors.ResultsClass I surgical outcomes were similar in MRI-negative patients and the patients with MTS on MRI (seizure-free rate at postoperative 2 years was 79.2% and 82% in the MRI-negative and MTS groups, respectively). In univariate analysis, history of febrile convulsions, presence of unilateral IEDs and left temporal localization were found to be significantly associated with seizure free outcome. Multivariate analysis revealed that independent predictors of a good outcome were history of febrile convulsions and presence of unilateral IEDs.ConclusionOur results suggest that epilepsy surgery outcomes of MRI-negative, PET positive patients are similar to those of patients with MTS. This finding may aid in the selection of best candidates for epilepsy surgery
Surgical outcome in patients with MRI-negative, PET-positive temporal lobe epilepsy
Purpose: The purpose of this study was to determine the long-term
surgical outcomes of magnetic resonance imaging (MRI)-negative,
fluorodeoxyglucose positron emission tomography (FDG-PET)-positive
patients with temporal lobe epilepsy (TLE) and compare them with those
of patients with mesial temporal sclerosis (MTS).
Methods: One hundred forty-one patients with TLE who underwent anterior
temporal lobectomy were included in the study. The surgical outcomes of
24 patients with unilateral temporal hypometabolism on FDG-PET without
an epileptogenic lesion on MRI were compared with that of patients with
unilateral temporal hypometabolism on FDG-PET with MTS on MRI (n = 117).
The outcomes were compared using Engel's classification at 2 years after
surgery. Clinical characteristics, unilateral interictal epileptiform
discharges (IEDs), histopathological data and operation side were
considered as probable prognostic factors.
Results: Class I surgical outcomes were similar in MRI-negative patients
and the patients with MTS on MRI (seizure-free rate at postoperative 2
years was 79.2\% and 82\% in the MRI-negative and MTS groups,
respectively). In univariate analysis, history of febrile convulsions,
presence of unilateral IEDs and left temporal localization were found to
be significantly associated with seizure free outcome. Multivariate
analysis revealed that independent predictors of a good outcome were
history of febrile convulsions and presence of unilateral IEDs.
Conclusion: Our results suggest that epilepsy surgery outcomes of
MRI-negative, PET positive patients are similar to those of patients
with MTS. This finding may aid in the selection of best candidates for
epilepsy surgery. (C) 2015 British Epilepsy Association. Published by
Elsevier Ltd. All rights reserved