Neuronavigation-assisted surgical treatments for medically refractory epilepsy: Single-hospital experience with 4 surgical approaches.

Objective: Surgical treatment should be considered for patients with medically refractory epilepsy, and neuronavigation may benefit and reduce the technical difficulties during surgery. In this study, we aimed to report our single-hospital experience of incorporating neuronavigation for treating patients with medically refractory epilepsy using 4 types of surgery.

Patients And Methods: Patients who were diagnosed as medically refractory epilepsy and received neuronavigation-assisted surgery were included in this retrospective analysis.

Surgical Treatment and Long-Term Outcome of Cerebral Cavernous Malformations-Related Epilepsy in Pediatric Patients.

Cerebral cavernous malformations (CMs) are vascular malformations affecting any part of the central nervous system. Clinical data and surgical outcomes for 27 pediatric patients with CM-related epilepsy were retrospectively reviewed. The mean age of onset was 12.

Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

Objective: Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits.

Methods: 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed.

Three-dimensional intracranial EEG monitoring in presurgical assessment of MRI-negative frontal lobe epilepsy.

Magnetic resonance imaging (MRI)-negative epilepsy is associated with poor clinical outcomes prognosis. The present study was aimed to assess whether intracranial 3D interictal and ictal electroencephalography (EEG) findings, a combination of EEG at a different depth, in addition to clinical, scalp EEG, and positron emission tomography-computed tomography (PETCT) data help to predict outcome in a series of patients with MRI-negative frontal lobe epilepsy (FLE) after surgery.Patients with MRI-negative FLE who were presurgically evaluated by 3D-intracranial EEG (3D-iEEG) recording were included.

Neuropsychological outcomes of subtemporal selective amygdalohippocampectomy via a small craniotomy.

OBJECT The objectives of this study were to describe a novel minimal-access subtemporal approach for selective resection of the amygdala and hippocampus in patients with medically refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis, and to analyze the related outcomes. METHODS The authors analyzed data from all cases involving patients with unilateral MTLE due to hippocampal sclerosis who were treated with selective amygdalohippocampectomy via the posterior subtemporal approach through a relatively small craniotomy, without a neuronavigation system, at their institution during the period from September 2010 to September 2012. Data were obtained on baseline characteristics, preoperative evaluations of unilateral mesial temporal sclerosis, surgical complications, and Engel class seizure outcomes.

Keyhole epilepsy surgery: corticoamygdalohippocampectomy for mesial temporal sclerosis.

Surgical approaches for medically refractory mesial temporal lobe epilepsy (MTLE) that previously have been reported include anterior temporal lobectomy (ATL), transcortical selective amygdalohippocampectomy, transsylvian amygdalohippocampectomy, and subtemporal amygdalohippocampectomy. Each approach has its advantages and potential pitfalls. The purpose of this report is to describe our technique of keyhole corticoamygdalohippocampectomy for patients with MTLE due to hippocampal sclerosis.

Long-term epilepsy surgery outcomes in patients with PET-positive, MRI-negative temporal lobe epilepsy.

This study compared the long-term efficacy of anterior temporal lobectomy (ATL) for the treatment of medically refractory temporal lobe epilepsy (TLE) in patients who presented with ipsilateral temporal PET hypometabolism and nonlesional magnetic resonance imaging (PET+/MRI-) with that in patients who had mesial temporal sclerosis (MTS) on MRI. We described the electroclinical, MRI, PET, and pathological characteristics and seizure outcome of 28 PET+/MRI--patients without discordant ictal and interictal electroencephalography (EEG) who underwent ATL (2004-2007) for medically refractory partial epilepsy while avoiding intracranial monitoring. The primary outcome was the percentages of Engel Class I outcomes at 2 and 5 years of PET+/MRI--patients compared with those of patients with MTS on MRI; neuropsychological testing was used as the secondary outcome.

Intractable occipital lobe epilepsy: clinical characteristics, surgical treatment, and a systematic review of the literature.

Purpose: We reported our experience in the surgical treatment of a relatively large cohort of patients with occipital lobe epilepsy (OLE). We also carried out a systematic review of the literature on OLE.

Methods: Thirty-five consecutive patients who underwent occipital resection for epilepsy were included.

Intracranial electroencephalography with subdural and/or depth electrodes in children with epilepsy: techniques, complications, and outcomes.

Intracranial electroencephalographic monitoring with subdural and/or depth electrodes is widely used for the surgical localization of epileptic foci in patients with intractable partial epilepsy; however, data on safety and surgical outcome with this technique are still inadequate. The aims of this study were to assess the morbidity of intracranial recordings and the surgical outcomes in epileptic children. We retrospectively reviewed the clinical data for 137 children with epilepsy (mean age at implantation: 12.

Disconnective surgery in posterior quadrantic epilepsy: a series of 12 paediatric patients.

Aim: To assess the surgical outcomes of temporo-parieto-occipital (TPO) and parieto-occipital (PO) disconnection surgery for children with intractable posterior quadrantic epilepsy and a unilateral posterior quadrant lesion based on MRI and functional imaging abnormality in the TPO region on one side.

Methods: A retrospective review of data of 12 children who underwent TPO or PO disconnective surgery was carried out from September 2009 to September 2012. Three-dimensional surface reconstructions of MRI scans and intraoperative electrophysiological monitoring were used during surgery.

Outcome after anterior callosal section that spares the splenium in pediatric patients with drop attacks.

We report on the efficacy and safety of extended, one-stage anterior callosal section that spares the splenium, which is performed in a large series of pediatric patients with drop attacks. Twenty-nine pediatric patients with drop attacks were studied (19 males and 10 females; mean age: 9.9 years).