%0 Journal Article
%T MRI Brain Findings in Adults with Lesional Refractory Epilepsy and Correlation to Surgical Outcome | Insight Medical Publishing
%A Abdulelah N ALJasser
%A Nawal ALAdwani
%A Sonia AS Khan
%J Index Copernicus Value: 87.45
%D 2018
%R 10.21767/2386-5180.1000216
%X Introduction: Refractory epilepsy which is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom is common in patients with structural brain lesions including acquired disorders and genetic abnormalities. High resolution Magnetic Resonance Imaging MRI of the brain has proven its precision as a diagnostic tool for recognition of different structural lesions underlying medically intractable seizures. Objective: To recognize common MRI lesions in a series of adult patients with refractory epilepsy admitted to the epilepsy monitoring unit at Prince Sultan Military Medical City PSMMC for pre surgical evaluation for epilepsy surgery with correlation to surgical outcome and to compare our local data with the international literature. Material and methods: 245 patients (100 Males and 145 Females; 14-53 years) with refractory epilepsy were included in this retrospective analysis. They presented with partial with or without complex partial seizures 112 (46.0%), partial with secondary generalized tonic clonic seizures 76 (31.0%) or generalized seizures in 57 (23.0%) of patients. Clinical diagnosis of epilepsy and seizure classification were based on the revised criteria of the International League Against Epilepsy ILAE. Structural neuroimaging MRI brain, functional neuroimaging which include Interictal Fluorodeoxyglucose Positron Emission Computed Tomography FDG-PET, Ictal Technetium-99m hexamethyl-propylene amine oxime Single Photon Emission Computed Tomography 99 m HMPAO SPECT, Electroencephalography EEG recording, epilepsy history and neurological examination were performed. MRI brain imaging epilepsy protocol used a 1.5 or 3 Tesla MRI scanner. All patients included in this study received appropriate epilepsy surgery and post-operative seizure control was followed in the epilepsy clinic with six-month post-operative inter ictal EEG, follow up MRI brain after epilepsy surgery were performed in all patients and 50 patients had additional video-EEG recording postoperative during the follow up period. Epilepsy surgery seizure control outcome was classified according to Engel Classification system. All patients were followed for at least two years post-operatively to assess seizure control. Pre-operative MRI diagnosis was correlated with the epilepsy surgery seizure control outcome. Results: MRI detected different structural brain abnormalities in 245 (100%) patients, including temporal lobe location in 142 (58%) patients,
%U http://www.aclr.com.es/clinical-research/mri-brain-findings-in-adults-with-lesional-refractory-epilepsy-and-correlation-to-surgical-outcome.php?aid=21880