A clinical study based on SEEG: epileptogenic mapping and surgery in pharmaco-resistant post-encephalitic temporal lobe epilepsy_Journal of Epilepsy

Authors：

 HUXiangshu , ZHANGWei , GUOQiang , LIUXingzhou , LIHua , FEILinxia , WANGXiao , XieYanping , CHENJunxi , WUXinyan , CHENQiao , SuJuping

Epileptic Center, Guangdong Sanjiu Brain Hospital, Guangzhou 510510, China;

Corresponding author：

HUXiangshu, Email: hxs75@126.com

Keywords：

Post-encephalitic epilepsy; SEEG; Temporal plus; Surgery

DOI：

10.7507/2096-0247.20160053

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ObjectivesPost-encephalitic epilepsy could be of great chance of pharmaco-resistant, even surgery may not achieve seizure free. The aim of this study is to mapping epileptogenic area of pharmaco-resistant post-encephalitic temporal lobe epilepsy, to find whether "temporal plus" epilepsy is the main type and its surgery outcome, based on stereo-EEG(SEEG) study.MethodWe retrospectively studied 15 patients with pharmaco-resistant temporal lobe epilepsy. Scalp EEG, seizure semiology, MRI, FDG-PET, and SEEG were reviewed for all patients. According to epileptogenic area which was analysed by SEEG, 15 patients were divided into 2 groups, temporal lobe epilepsy(TLE) group and temporal plus epilepsy(TPE) group. Clinical characteristics were compared with each group, by t-test or Fisher exact test when data needed.ResultsThere were 8 patients in TLE group, with 6 mesial TLE, 1 lateral TLE, 1 mesial-lateral TLE. And 7 patients in TPE group. Age of seizure onset (P=0.548), duration of epilepsy (P=0.099), age of remote encephalitis (P=0.385), type of semiology (P=0.315) and lateralization of MR lesions (P=1.000), interictal FDG-PET hypometabalism (P=1.000) or intracranial implantation (P=0.619) were of no statistically difference between TLE group and TPE group. Surgery was performed in all patients. Better outcome was obtained in TLE group(5/8 class Ⅰ), and poor was in TPE group(3/7class Ⅰ).ConclusionMesial-TLE and temporal plus epilepsy were common types of pharmaco-resistant post-encephalitic TLE. There was no way to differentiate clinically, except by SEEG. Mesial-TLE had a better outcome after surgery, but temporal plus epilepsy did not.

Citation： HUXiangshu, ZHANGWei, GUOQiang, LIUXingzhou, LIHua, FEILinxia, WANGXiao, XieYanping, CHENJunxi, WUXinyan, CHENQiao, SuJuping. A clinical study based on SEEG: epileptogenic mapping and surgery in pharmaco-resistant post-encephalitic temporal lobe epilepsy. Journal of Epilepsy, 2016, 2(4): 296-307. doi: 10.7507/2096-0247.20160053 Copy

1.	D Bhalla, B Godet, M Druet-Cabanac, et al. Etiologies of epilepsy:a comprehensive review. Expert Rev Neurother, 2011, 11(5):861-876.
2.	J Sellner, E Trinka. Seizures and epilepsy in herpes simplex virus encephalitis:current concepts and future directions of pathogenesis and management. J Neurol, 2012, 259(11):2019-2030.
3.	YJ Chen, PC Fang, JC Chow. Clinical characteristics and prognostic factors of postencephalitic epilepsy in children. J Child Neurol, 2006, 21(5):1047-1051.
4.	ME Lancman, HH Morris Ⅲ. Epilepsy after central nervous system infection:clinical characteristics and outcome after epilepsy surgery. Epilepsy Research, 1996, 25(7):285-290.
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6.	P Kahane, C Barba, S Rheims, et al. The concept of temporal 'plus' epilepsy. Revue Neurologique, 2015, 171(8):267-272.
7.	C Barba, S Rheims, L Minotti, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(9):444-451.
8.	郭强, 朱丹, 张玮, 等.立体脑电图在药物难治性癫痫患者术前评估中的应用.中华神经外科杂志, 2016, 32(3):261-265.
9.	P Kahane, E Landré, L Minotti, et al. The Bancaud and Talairach view on the epileptogenic zone:a working hypothesis. Epileptic Disord, 2006, 8 (Suppl. 2):16-26.
10.	张绍辉, 张军臣, 胡晓红, 等.单侧前颞叶切除治疗偏侧癫痫发作起源优势的双侧颞叶癫痫.癫痫杂志, 2015, 1(1):43-47.
11.	P Kahane, F Bartolomei. Temporal lobe epilepsy and hippocampal sclerosis:lessons from depth EEG recordings. Epilepsia, 2010, 51(Suppl. 1):59-62.
12.	E Trinka, F Dubeau, F Andermann, et al. Successful epilepsy surgery in catastrophic postencephalitic epilepsy. Neurology, 2000, 54(10):2170-2173.
13.	C Barba, G Barbati, L Minotti, et al. Ictal clinical and scalp-EEG findings differentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 2007, 130(11):1957-1967.
14.	H Liiders, J Acharya, C Baumgartner, et al. Semiological Seizure Classification. Epilepsia, 1998, 39(10):1006-1013.
15.	E Guedj, F Bonini, M Gavaret, et al. 18FDG-PET in different subtypes of temporal lobe epilepsy:SEEG validation and predictive value. Epilepsia, 2015, 56(8):414-421.
16.	AF Struck, LT Hall, JM Floberg, et al. Surgical decision making in temporal lobe epilepsy:A comparison of[¹⁸F] FDG-PET, MRI, and EEG. Epilepsy & Behavior, 2011, 22(7):293-297.
17.	C Rathore, JC Dickson, R Teotónio, et al. The utility of 18F-fluorodeoxyglucose PET (FDG-PET) in epilepsy surgery. Epilepsy Research, 2014, 108(20):1306-1314.

1. D Bhalla, B Godet, M Druet-Cabanac, et al. Etiologies of epilepsy:a comprehensive review. Expert Rev Neurother, 2011, 11(5):861-876.
2. J Sellner, E Trinka. Seizures and epilepsy in herpes simplex virus encephalitis:current concepts and future directions of pathogenesis and management. J Neurol, 2012, 259(11):2019-2030.
3. YJ Chen, PC Fang, JC Chow. Clinical characteristics and prognostic factors of postencephalitic epilepsy in children. J Child Neurol, 2006, 21(5):1047-1051.
4. ME Lancman, HH Morris Ⅲ. Epilepsy after central nervous system infection:clinical characteristics and outcome after epilepsy surgery. Epilepsy Research, 1996, 25(7):285-290.
5. E Trinka, F Dubeau, F Andermann, et al. Clinical findings, imaging characteristics and outcome in catastrophic postencephalitic epilepsy. Epileptic disord, 2000, 62(2):153-162.
6. P Kahane, C Barba, S Rheims, et al. The concept of temporal 'plus' epilepsy. Revue Neurologique, 2015, 171(8):267-272.
7. C Barba, S Rheims, L Minotti, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(9):444-451.
8. 郭强, 朱丹, 张玮, 等.立体脑电图在药物难治性癫痫患者术前评估中的应用.中华神经外科杂志, 2016, 32(3):261-265.
9. P Kahane, E Landré, L Minotti, et al. The Bancaud and Talairach view on the epileptogenic zone:a working hypothesis. Epileptic Disord, 2006, 8 (Suppl. 2):16-26.
10. 张绍辉, 张军臣, 胡晓红, 等.单侧前颞叶切除治疗偏侧癫痫发作起源优势的双侧颞叶癫痫.癫痫杂志, 2015, 1(1):43-47.
11. P Kahane, F Bartolomei. Temporal lobe epilepsy and hippocampal sclerosis:lessons from depth EEG recordings. Epilepsia, 2010, 51(Suppl. 1):59-62.
12. E Trinka, F Dubeau, F Andermann, et al. Successful epilepsy surgery in catastrophic postencephalitic epilepsy. Neurology, 2000, 54(10):2170-2173.
13. C Barba, G Barbati, L Minotti, et al. Ictal clinical and scalp-EEG findings differentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 2007, 130(11):1957-1967.
14. H Liiders, J Acharya, C Baumgartner, et al. Semiological Seizure Classification. Epilepsia, 1998, 39(10):1006-1013.
15. E Guedj, F Bonini, M Gavaret, et al. 18FDG-PET in different subtypes of temporal lobe epilepsy:SEEG validation and predictive value. Epilepsia, 2015, 56(8):414-421.
16. AF Struck, LT Hall, JM Floberg, et al. Surgical decision making in temporal lobe epilepsy:A comparison of[¹⁸F] FDG-PET, MRI, and EEG. Epilepsy & Behavior, 2011, 22(7):293-297.
17. C Rathore, JC Dickson, R Teotónio, et al. The utility of 18F-fluorodeoxyglucose PET (FDG-PET) in epilepsy surgery. Epilepsy Research, 2014, 108(20):1306-1314.

Journal of Epilepsy

A clinical study based on SEEG: epileptogenic mapping and surgery in pharmaco-resistant post-encephalitic temporal lobe epilepsy

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