Localization and microsurgical management of epileptogenic nidus of traumatic epilepsy / 中华创伤杂志

ABSTRACT

Objective To investigate the localization and surgical outcome of epileptogenic nidus of post-traumatic epilepsy. Methods A retrospective analysis was performed on clinical data of 62 patients with post-traumatic epilepsy treated microsurgicallly from November 2005 to May 2009. There were 48 males and 14 females, at age range from 11 to 48 years old (average 28.8 years old). The epileptogenic nidus in 59 patients was localized based on clinical manifestations, visual electroencephalography (V-EEC) imaging and electrophysiological findings and that in three patients localized by implanted intracranial electrodes. Under electrocorticogram (ECoG) monitoring, we resected cerebral malacia in 36 patients, removed both malacia and epileptogenic nidus in 15, and partially resected cerebral malacia combined with cortex thermocoagulation in 11. Results The follow-up for 6-33 months showed that there were 32 patients at grade Ⅰ , 17 at grade Ⅱ , nine at grade Ⅲ and four at grade Ⅳ according to Engel classification system. Conclusion V-EEG is an important method for pre-operative localization of epileptogenic nidus of post-traumatic epilepsy. Microsurgical management can attain favorable outcome under ECoG monitoring.