Clinical characteristics and surgical outcomes of patients with posterior parietal cortex epilepsy confirmed by stereoelectroencephalography
SHI Xian-jun
SUN Xiao-qin
WANG Zhi-ji
DENG Jing
FENG Lin
LIU Li-hong
ZHANG Chun-qing
LIU Shi-yong
Abstract：Objective To explore the clinical characteristics and surgical outcomes of patients with posterior parietal cortex(PPC)epilepsy confirmed by stereoelectroencephalography(SEEG).Methods A retrospective analysis was conducted on the clinical data of 16 patients with PPC epilepsy confirmed by SEEG from January 2017 to June 2023.All patients underwent local cortical resection under neuro-navigation.Results MRI showed lesions in 4 cases and was negative in 12 cases.PET was positive in all 16 cases.Scalp EEG localized seizures to one hemisphere in 5 cases and showed lateralizing tendencies in 6 cases;it localized seizures to the posterior head region in 8 cases and the anterior head region in 2 cases.SEEG localization:superior parietal lobule(SPL)in 6 cases,inferior parietal lobule(IPL)in 6 cases,and precuneus(Pcu)in 4 cases.Seizures originating from SPL and IPL rapidly propagated to the PCC and Pcu.Four cases with Pcu onset rapidly involved ipsilateral/bilateral PCC.Postoperative follow-up ranged from 16 to 88 months(median:57.5 months;IQR:29.5～74.5 months).ILAE class 1 and class 2 was achieved in 11 cases(68.8%),class 3 in 4 cases(25.0%),and class 4 in 1 case(6.3%).Three patients(18.8%,seizure-free>42 months)relapsed during medication tapering;after resuming medication,2 reached ILAE class 1 and 1 reached class 3.No patient achieved complete medication withdrawal.Conclusion PPC epilepsy presents with diverse symptoms and is challenging to localize via scalp EEG.SEEG and multimodal imaging enable precise localization.PCC and Pcu serve as critical nodes for early seizure propagation.Favorable surgical outcomes can be achieved in these patients.
Keywords：Posterior parietal cortex epilepsyStereoelectroencephalographyClinical characteristicsSurgical outcomes
Publication Date：2025-06-25
Online Publishing Date：2025-09-05(First online date of this platform, not the publication date of the document)
Pages：5( 321-325 )