Surgical treatment of polymicrogyria ‐related epilepsy

Summary
ObjectiveThe role of resective surgery in the treatment of polymicrogyria (PMG)–related focal epilepsy is uncertain. Our aim was to retrospectively evaluate the seizure outcome in a consecutive series of patients with PMG‐related epilepsy who received, or did not receive, surgical treatment, and to outline the clinical characteristics of patients who underwent surgery.
MethodsWe evaluated 64 patients with epilepsy associated with magnetic resonance imaging (MRI)–documented PMG. After presurgical evaluation, 32 patients were excluded from surgical treatment and 32 were offered surgery, which was declined by 8 patients. Seizure outcome was assessed in the 40 nonsurgical and 24 surgical patients.
ResultsOf 40 nonsurgical patients, 8 (20%) were seizure‐free after a mean follow‐up of 91.7 ± (standard deviation) 59.5 months. None of the eight patients who declined surgical treatment was seizure‐free (mean follow‐up: 74.3 ± 60.6 months). These seizure outcomes differ significantly (p = 0.000005 and p = 0.0003, respectively) from that of the 24 surgical patients, 18 of whom (66.7%) were Engel's class I postoperatively (mean follow‐up: 66.5 ± 54.0 months). Of the eight patients excluded from surgery for seizure control at first visit, two had seizure recurrence at last contact. At last contact, antiepileptic drugs (AEDs) had been withdrawn in 6 of 24 surgical and in one of 40 nonsurgical cases (p = 0.0092).
SignificanceThe present study indicates that, at le...

Source: Epilepsia - October 24, 2016 Category: Neurology Authors: Massimo Cossu, Veronica Pelliccia, Francesca Gozzo, Giuseppe Casaceli, Stefano Francione, Lino Nobili, Roberto Mai, Laura Castana, Ivana Sartori, Francesco Cardinale, Giorgio Lo Russo, Laura Tassi Tags: Full ‐Length Original Research Source Type: research