Long-Term Seizure Outcome in Patients Undergoing Resection of Lesions Detected by Magnetic Resonance Imaging

Kouzo MORITAKE; Nobuhiro MIKUNI; Yasuhiko AKIYAMA; Hidemasa NAGAI; Nobuyuki MARUYAMA; Daikei TAKADA; Keiji SUGIMOTO; Noriko NAGASAKO; Nobuo HASHIMOTO

doi:10.2176/nmc.48.546

Original Articles

Long-Term Seizure Outcome in Patients Undergoing Resection of Lesions Detected by Magnetic Resonance Imaging

Kouzo MORITAKE, Nobuhiro MIKUNI, Yasuhiko AKIYAMA, Hidemasa NAGAI, Nobuyuki MARUYAMA, Daikei TAKADA, Keiji SUGIMOTO, Noriko NAGASAKO, Nobuo HASHIMOTO

Author information

Kouzo MORITAKE
Department of Neurosurgery, Shimane University School of Medicine
Nobuhiro MIKUNI
Department of Neurosurgery, Kyoto University Graduate School of Medicine
Yasuhiko AKIYAMA
Department of Neurosurgery, Shimane University School of Medicine
Hidemasa NAGAI
Department of Neurosurgery, Shimane University School of Medicine
Nobuyuki MARUYAMA
Department of Neurosurgery, Shimane University School of Medicine
Daikei TAKADA
Department of Neurosurgery, Shimane University School of Medicine
Keiji SUGIMOTO
Department of Neurosurgery, Shimane University School of Medicine
Noriko NAGASAKO
Department of Neurosurgery, Shimane University School of Medicine
Nobuo HASHIMOTO
Department of Neurosurgery, Kyoto University Graduate School of Medicine

Keywords: epilepsy surgery, lesionectomy, extratemporal location, long-term seizure outcome, magnetic resonance imaging

JOURNAL OPEN ACCESS

2008 Volume 48 Issue 12 Pages 546-553

DOI https://doi.org/10.2176/nmc.48.546

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Abstract

The long-term efficacy of resective surgery was investigated in patients with lesions detected by magnetic resonance (MR) imaging. Thirty of 47 patients who had undergone lesionectomy between 1987-2001 were followed up by questionnaire. Patients with extratemporal resections outnumbered those with temporal lobe resections. The mean follow-up period was 12.4 ± 3.7 years. Outcomes were graded according to Engel’s criteria, and an arbitrary seizure outcome score was given for quantitative assessment. The mean seizure outcome scores were significantly lower in the early childhood (less than 3 years) onset group than in the late childhood (3 to 15 years) onset group, and significantly lower in the extratemporal resection of the cortical dysplasia group than in the temporal resection and the extratemporal resection of non-cortical dysplasia groups. This study indicated that lesionectomy based on MR imaging findings in patients with intractable epilepsy achieved effective long-term seizure control, and the outcome was related mainly to the pathology of the epileptogenic lesions and the temporal or extratemporal location.

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