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Surgical treatment of MRI-negative drug resistant epilepsy in children

https://doi.org/10.17749/2077-8333/epi.par.con.2022.110

Abstract

Objective: analysis of treatment tactics for patients with magnetic-resonance-imaging (MRI) negative epilepsy, characteristics of morphological data and assessment of the treatment results.

Material and methods. Within the period of 2013–2021, 31 patients under the age of 18 with drug-resistant nonlesional epilepsy were examined according to the “epilepsy” MRI-protocol. Patient distribution by gender, age, duration of illness, age of onset, number of anticonvulsant protocols, frequency of seizures at the time of initiated treatment, side and lobe of the seizure generation zone was analyzed. The instrumental diagnostic methods were noted in a specially designed study form and reported contribution of relevant result to epileptogenic zone. The distribution of patients according to surgical intervention and histological data was also analyzed.

Results. Resection surgery was carried out in 26 (83.9%) patients. Palliative operations were performed in 5 (16.1%) cases with bilateral localization of the epileptic focus: callosotomy (3) and vagal nerve stimulation (2). Twelve months post-therapy outcomes by Engel class I were found in 19 (61.3%) patients, class II – in 6 (19.4%), class III – in 5 (16.1%), and class IV – in 1 (3.2%). Long-term results of surgical treatment were assessed 3 and 5 years later.

Conclusion. Surgery of MRI-negative epilepsy can be effective with seizure-free outcome in 61.3% of cases, but requires use of additional diagnostic methods in relation to standard pre-surgery examination to localize epileptogenic zone.

About the Authors

M. R. Mamatkhanov
Almazov National Medical Research Centre
Russian Federation

Magomed R. Mamatkhanov – Dr. Med. Sc., Senior Researcher, Research Laboratory of Pediatric Neurosurgery

Saint Petersburg

RSCI SPIN-code: 7426-2245.



V. V. Ushanov
Almazov National Medical Research Centre
Russian Federation

Vseslav V. Ushanov – Clinical Resident, Chair of Neurosurgery

Saint Petersburg



A. P. Gerasimov
Almazov National Medical Research Centre
Russian Federation

Alexandr P. Gerasimov – MD, Senior Researcher, Research Laboratory of Pediatric Neurosurgery

Saint Petersburg

RSCI SPIN-code: 9108-9354



W. A. Khachatryan
Almazov National Medical Research Centre
Russian Federation

William A. Khachatryan – Dr. Med. Sc., Professor, Head of Research Laboratory of Pediatric Neurosurgery

Saint Petersburg, Russia

WoS ResearcherID: G-4002- 2018;

RSCI SPIN-code: 7555-8039.

 



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Review

For citations:


Mamatkhanov M.R., Ushanov V.V., Gerasimov A.P., Khachatryan W.A. Surgical treatment of MRI-negative drug resistant epilepsy in children. Epilepsy and paroxysmal conditions. 2022;14(2):195-203. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2022.110

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)