Surgery for perirolandic epilepsy: Epileptogenic cortex resection guided by chronic intracranial electroencephalography and electric cortical stimulation mapping.
METHODS
The objective of this study was to assess outcome with regard to seizure status and neurological function in patients undergoing resective surgery involving the perirolandic area.


METHODS
All 15 patients who underwent perirolandic cortical resection between October 2006 and September 2007 at the Comprehensive Epilepsy Centre of Beijing Xuanwu Hospital were included in the study. The locations of functional cortical areas, ictal onset zones and epileptogenic lesions were mapped by chronic intracranial EEG recordings and electric cortical stimulation. Seizure outcome was determined using the modified classification of Engel and colleagues. Motor and sensory deficits were monitored.


RESULTS
At last follow-up 5 patients (33%) were in Engel class I, 4 (27%) were in class II, 3 (20%) were in class III, and 3 (20%) were in class IV. Nine patients suffered immediate functional deficits; 8 of these recovered completely within 2 weeks to 3 months of surgery. One had mild persistent loss of finger motor control.


CONCLUSIONS
After accurate presurgical evaluation using invasive recordings and functional brain mapping, epileptogenic cortical resection can give excellent results and few deficits in patients with perirolandic epilepsy.
DuanYu
Ni
N
Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
GuoJun
Zhang
Z
Liang
Qiao
Q
LiXin
Cai
C
Tao
Yu
Y
YongJie
Li
L
D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000473:pathology* / Q000503:physiopathology; D004558:Electric Stimulation; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009044:Motor Cortex / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology; D012535:Scalp; D012640:Seizures / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult