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Title

Epilepsia farmacorresistente del lóbulo temporal. Exploración con electrodos del foramen oval y resultados quirúrgicos

Other TitlesPharmacoresistant temporal-lobe epilepsy. Exploration with foramen ovale electrodes and surgical outcomes
AuthorsSola, Rafael G.; Hernando-Requejo, V.; Pastor, J.; García-Navarrete, E.; DeFelipe, Javier ; Alijarde, M. T.; Sánchez-Gracia, Alejandro ; Domínguez-Gadea, L.; Martín-Plasencia, P.; Maestú, Fernando; Ramón y Cajal Junquera, Santiago; Pulido, Paloma
KeywordsEpilepsy surgery
Foramen ovale electrodes
Pharmacoresistance
Temporal lobectomy
Temporal-lobe epilepsy
Cirugía de la epilepsia
Electrodos del foramen oval
Epilepsia del lóbulo temporal
Farmacorresistencia
Lobectomía temporal
Issue Date2005
PublisherViguera Editores
CitationRevista de Neurología 41(1): 4-16 (2005)
Abstract[EN] [Aim] To report our experience in the surgical treatment of temporal-lobe epilepsy. [Patients and methods] An analysis was performed of the outcomes of 137 patients submitted to surgery between 1990 and 2001, with a follow-up of more than two years. A study was conducted of the percentages of successful detection by the different complementary tests – MRI, EEG, interictal SPECT, video-EEG with foramen ovale electrodes (FOE), neuropsychological study (NPS) – and the precision with which they reported the epileptogenic focus.
[Results and conclusions] Successful surgical outcomes (Engel grades I-II): 73.4%. No surgical mortality occurred, although some mild, reversible morbidity was observed. Surgical outcomes were not affected by sex, age, age of onset and the length of time the patient had had the disease, or the frequency of the seizures. No association was found between seizures in the immediate post-operative period and a poorer long term control of the epilepsy. MR images were normal in 25% of patients; in these cases the surgical outcomes (Engel grades I-II at two years: 62%) were significantly poorer than in cases of tumours/cavernomas (86%); RMI studies of other types of lesions gave intermediate results (72%). With respect to the capacity of the different tests to lateralise/locate the epileptogenic focus, video-EEG-FOE proved to be the best, followed by MRI, SPECT, EEG and NPS.
[ES] [Objetivo] Presentar nuestra experiencia en el tratamiento quirúrgico de la epilepsia del lóbulo temporal. [Pacientes y métodos] Se analizan resultados en 137 pacientes, intervenidos quirúrgicamente entre 1990 y 2001, con seguimiento mayor de dos años. Se estudia el porcentaje de aciertos de las pruebas complementarias –RM, EEG, SPECT interictal, vídeo-EEG con electrodos del foramen oval (EFO), estudio neuropsicológico (NPS)– y la precisión con que informaron del foco epileptógeno.
[Resultados y conclusiones] Éxitos quirúrgicos (grados I-II de Engel): 73,4%. No hubo mortalidad quirúrgica, aunque sí escasa morbilidad, leve y reversible. No modificaron los resultados quirúrgicos ni el sexo, edad, edad de comienzo y tiempo de desarrollo de la enfermedad, ni la frecuencia de las crisis. No encontramos asociación entre crisis en el postoperatorio inmediato y peor control de la epilepsia a largo plazo. La RM fue normal en el 25% de los pacientes; en ellos, los resultados quirúrgicos (grados I-II de Engel a los dos años: 62%) fueron significativamente peores que en los casos de tumor/cavernoma (86%); ante otras lesiones en la RM, el resultado fue intermedio (72%). En relación a la capacidad lateralizadora/localizadora del foco epileptógeno de las diferentes pruebas, destaca el vídeo-EEG-EFO, seguido de la RM, SPECT, EEG y NPS.
Description13 págs, 11 figs, 6 tabs.-- PMID: 15999323.
Publisher version (URL)http://www.revneurol.com/sec/resumen.php?or=web&i=e&id=2004550&vol=41&num=01
URIhttp://hdl.handle.net/10261/8630
ISSN0210-0010
E-ISSN1576-6578
Appears in Collections:(IC) Artículos
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