title: Retrospective analysis of variables favouring good surgical outcome in posterior epilepsies.
abstract: OBJECTIVE
  to determine variables favouring good surgical outcome in posterior epilepsies.
  
  
  METHODS
  Fourteen patients submitted to epilepsy surgery were included in the study. The epileptogenic zone was located in temporo-parieto-occipital areas as assessed by both invasive and non-invasive pre-surgical evaluation. Several variables (age at first seizure; age at surgery; disease duration; type, frequency and clinical semiology of seizures; presence of lesion; scalp ictal and interictal EEG; localization and extension of epileptogenic zone; completeness of surgical resection) were compared (Fisher's exact test) with freedom from seizures to determine whether surgical outcome (Engel's classification) could be related to any of them.
  
  
  RESULTS
  Seven patients were seizure free (Ia) and very satisfying results were obtained for 3 patients (2 Ib, 1 Ic). New post-surgical visual deficits occurred only in 3 patients. Surgical outcome was related significantly to two variables: scalp ictal EEG (focal versus non-focal; p: 0.014) and completeness of surgical resection of epileptogenic zone (p: 0.0023). A significant trend towards a better outcome for focal interictal intracranial activity versus a non-focal one (p: 0.07) was found.
  
  
  CONCLUSIONS
  The correlation between completeness of epileptogenic zone resection and surgical outcome suggests that a presurgical protocol, allowing a precise definition of the area of resection, could help in obtaining more satisfying results in posterior epilepsies.
authors.affiliation: Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306, 00179 Rome, Italy. carmen.barba@tiscali.it
authors.forename: Carmen
authors.initials: C
authors.lastname: Barba
authors.forename: F
authors.initials: F
authors.lastname: Doglietto
authors.forename: L
authors.initials: L
authors.lastname: De Luca
authors.forename: G
authors.initials: G
authors.lastname: Faraca
authors.forename: C
authors.initials: C
authors.lastname: Marra
authors.forename: M
authors.initials: M
authors.lastname: Meglio
authors.forename: G F
authors.initials: GF
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Colicchio
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001931:Brain Mapping; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009493:Neurosurgery / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome
references.citation: Neurology. 1979 May;29(5):705-16
references.pmid: 571569
references.citation: Epilepsia. 1993 Jan-Feb;34(1):84-96
references.pmid: 8422868
references.citation: Epilepsia. 1999 Mar;40(3):257-66
references.pmid: 10080503
references.citation: Brain. 1992 Dec;115 ( Pt 6):1655-80
references.pmid: 1486456
references.citation: Confin Neurol. 1966;27(1):91-4
references.pmid: 5334025
references.citation: Stereotact Funct Neurosurg. 2001;77(1-4):29-32
references.pmid: 12378053
references.citation: Brain. 2002 Oct;125(Pt 10):2320-31
references.pmid: 12244088
references.citation: Epilepsia. 2000 Dec;41(12):1567-73
references.pmid: 11114215
references.citation: Brain. 2000 Aug;123 ( Pt 8):1733-51
references.pmid: 10908202
references.citation: J Neurol Neurosurg Psychiatry. 2003 Nov;74(11):1493-501
references.pmid: 14617703
references.citation: J Neurol Neurosurg Psychiatry. 1994 Jan;57(1):58-65
references.pmid: 8301306
references.citation: Epilepsia. 1996 Sep;37(9):814-21
references.pmid: 8814093
references.citation: Acta Neurochir (Wien). 1999;141(8):819-24
references.pmid: 10536717
references.citation: Brain. 2001 Sep;124(Pt 9):1683-700
references.pmid: 11522572
references.citation: Epilepsia. 1999 Jul;40(7):880-90
references.pmid: 10403211
references.citation: Acta Neurol Scand Suppl. 1994;152:56-67, discussion 68-9
references.pmid: 8209659
references.citation: Ann Neurol. 2000 Oct;48(4):614-23
references.pmid: 11026445
references.citation: Neurology. 2000 Apr 11;54(7):1470-6
references.pmid: 10751260
references.citation: Seizure. 2002 Apr;11(3):184-92
references.pmid: 12018962
references.citation: N Engl J Med. 1996 Mar 7;334(10):647-52
references.pmid: 8592530
references.citation: Rev Neurol (Paris). 2002 May;158(5 Pt 2):4S55-64
references.pmid: 11997752
references.citation: N Engl J Med. 2001 Aug 2;345(5):365-7
references.pmid: 11484695
references.citation: Acta Neurol Scand. 1993 Jun;87(6):434-7
references.pmid: 8356870
references.citation: Ann Neurol. 1982 Apr;11(4):428-32
references.pmid: 6808892
references.citation: Brain. 2002 Aug;125(Pt 8):1719-32
references.pmid: 12135964
references.citation: Ann Neurol. 1991 Jun;29(6):638-45
references.pmid: 1892366
references.citation: Epilepsia. 2001 Jul;42(7):889-94
references.pmid: 11488889
references.citation: J Neurol Neurosurg Psychiatry. 1999 Mar;66(3):350-6
references.pmid: 10084534