Clinical features and surgical treatment for posterior cortex epilepsy / 中华神经科杂志

ABSTRACT

Objective To characterize the clinical features and assess the role of surgery in posterior cortex epilepsy. Methods A retrospective analysis of clinical data was performed in 43 patients with posterior cortex epilepsy. The diagnosis Was established by means of a standard presurgical evaluation, including ictal semiology, MRI, interictal and ictal scalp video-EEG, and additional intracranial EEG monitoring in selected cases. Results The 43 patients included 11 parietal lobe epilepsy, 13 occipital lobe epilepsy, and 19 patients with seizures originating from other part of posterior cortex. Thirty-three patients (76.7%)experienced at least one type of aura, such as visual aura, somatosensory aura, dizziness and so on. The common ictal manifestations included deviation, automatisms, tonic posture and so on. Intracranial EEG monitoring was preformed in 22 selected cases. Transient contralateral hemiparesis occurred in 2 patients, mixed aphasia in 1 patient, and they recovered in 3 weeks after surgery. Visual and visual field deficits were observed in 5 patients, and they did not fully recovered. All patients were followed-up 1 to 5 years, and 27(62.8%)became seizure free (Engel' S I class). Conclusions Some of the specific auras or ictal manifestations may indicate posterior cortex epilepsy. Favorable surgical outcome has been achieved in many of the patients.