Common methods to evaluate refractory epilepsy preoperatively and their effects on localization of epileptogenic foci
DU Hao
HUANG Ling-yue
XIANG Lu
LIU Qin
Lü Li-hui
CHEN Lu-lu
XU Guo-zheng
Abstract：Objective To analyze common methods to evaluate refractory epilepsy preoperatively and their effects on localization of epileptogenic foci in order to provide reasonable method for preoperative evaluation of refractory epilepsy.Methods The clinical data of 76 patients with refractory epilepsy who underwent surgery from September,2011 to October,2013 in our department were analyzed retrospectively,including the effects of clinical symptoms,scalp and intracranial electroencephalogram (EEG) and imaging on the localization of epileptogenic foci and so on.Results The clinical symptoms,brain MRI and scalp EEG provided some useful information for localization and lateralization of epileptogenic foci before the surgery respectively in 88.1％,44.7％ and 82.9％ of the patients with refractory epilepsy.N-acetyl-aspartaste (NAA)/[creatine(Cr)+ choline(Cho)] ratio in the unilaterally or bilateral hippocampal heads decreased in 33 patients accepting magnetic resonance spectroscopy (MRS).In 20 patients with mesial temporal lobe epilepsy MRS (MTLE),the NAA/(Cr+Cho) ratio was significantly lower in the side with epileptogenic foci than that in the opposite side of cerebrum (P＜ 0.05),but the epileptogenic foci were correctly located by the low NAA/(Cr+Cho) ratio only in 12 patients.In 13 of 19 (88.4％) patients without structural abnormalities confirmed by MRI,positron emission tomography (PET) provided the certain information for the localization and lateralization of the epileptogenic foci.The epileptogenic foci were correctly localized by the intracranial EEG in 52 patients with refractory epilepsy before the surgery.Conclusions The clinical symptoms,brain MRI,scalp EEG,and PET can provide some useful information for the localization and lateralization of the epileptogenic foci before the surgery in the patients with refractory epilepsy.MRS may provide the information in some degree for the epileptogenic foci lateralization in the patients with MTLE.The intracranial EEG still plays a decisive role in localization of the epileptogenic foci in the patients with refractory epilepsy before the surgery.
Keywords：Refractory epilepsyPreoperative evaluationEpileptogenic fociLocalization
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 224-227 )