The Study of the Corresponding Relationship between V-EEG and MRI on Patients Underwent Epilepsy Surgery
|School||Huazhong University of Science and Technology|
|Keywords||Epilepsy surgery Video-Electroencephalography Magnetic Resonance Imaging Epileptogenic focus Seizure outcome|
Objectives: To discuss the corresponding relationship between different lesions displayed by MRI and abnormal discharges showed on V-EEG and the probable mechanism. The purpose of this study was to guide the preoperative planning and predict the prognosis before operation by analyzing the influence on seizure outcome of epilepsy surgery with the consistency of V-EEG and MRI in localizing epileptogenic focus.Methods: This study included 42 selected patients with intractable epilepsy who had underwent surgery at the epilepsy centre of Tongji hospital in Wuhan during April 2007 to April 2010.Clinical and follow-up data of all patients were reviewed. Retrospectively analyze the correlation between V-EEG and MRI combining with pathology. Chi-square test was used to compare the outcome of epilepsy surgery between patients whose V-EEG were consistent with MRI and the ones whose V-EEG were inconsistent with MRI. Seizure outcome was evaluated according to Engel’s classification.Results: Interictal epileptiform discharges were detected by V-EEG in 85.7%(36/42) patients. The consistency of V-EEG and MRI reaches 57.1% in lateralizing epilepogenic focus. Postoperative outcome in the group with consistency between V-EEG and MRI had statistically significant in comparison to the group with inconsistency(P=0.044). Among these patiens,15(35.7%)cases obtained Engel Class I outcome(seizure free, auras only or occasional generalized convulsion with AED withdrawal), the total effective rate of surgery was 61.9%.Different MRI findings might appear“contained”,“adjacent”,“diffuse”or“separated”relationship to abnormal discharges on V-EEG in space.Conclusions: Epilepsy surgery is the effective treatment for patients with intractable epilepsy. According to the region with interictal epileptiform discharges revealed by V-EEG and MRI findings, we could localize epilepogenic focus accurately and determine the range of resection. When V-EEG was consistent with MRI ,it predicts a favorable prognosis.