Preoperative mapping for patients with supplementary motor area epilepsy: multimodality brain mapping.
Surgical management and strategies for the supplementary motor area (SMA) epilepsy are described. The following is our preoperative evaluations. The steps include functional magnetic resonance imaging (fMRI), interictal dipole tracing (DT), subdural electrodes mapping, measurements of movement-related cortical potential (MRCP), and the use of the intraoperative open MRI under conscious craniotomy. Six patients with SMA epilepsy underwent surgery after the mapping procedures and are now seizure-free. Combinations of preoperative (fMRI, subdural electrodes mapping) and intraoperative mapping allow exact localization and identification of the critical functional areas. Early postoperative deficits in motor and speech function were profound but patients recovered rapidly. It is concluded that the step of mapping procedures plays an important role in the management of SMA epilepsy surgery.
Yamane
Fumitaka
F
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo. fyamane@nij.twmu.ac.jp
Muragaki
Yoshihiro
Y
Maruyama
Takashi
T
Okada
Yoshikazu
Y
Iseki
Hiroshi
H
Ikeda
Akio
A
Homma
Ikuo
I
Hori
Tomokatsu
T
D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D004569:Electroencephalography; D020938:Epilepsy, Partial, Motor / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009044:Motor Cortex / Q000473:pathology* / Q000601:surgery; D009068:Movement / Q000502:physiology; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000523:psychology