Browse

Frontal lobe epilepsy: clinical characteristics, surgical outcomes and diagnostic modalities

Cited 55 time in Web of Science Cited 73 time in Scopus
Authors
Lee, Jung Ju; Lee, Sang Kun; Lee, Seo-Young; Park, Kyung-Il; Kim, Dong Wook; Lee, Dong Soo; Chung, Chun Kee; Nam, Hyeon Woo
Issue Date
2008-03-11
Publisher
Elsevier
Citation
Seizure. 2008;17(6):514-523
Keywords
AdolescentAdultChildDiagnostic Imaging/*methodsElectroencephalography/methodsEpilepsy, Frontal Lobe/*diagnosis/*surgeryFemaleFluorodeoxyglucose F18/diagnostic useFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedNeurosurgical Procedures/*methodsPositron-Emission TomographyRetrospective StudiesTechnetium Tc 99m ExametazimeTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedTreatment Outcome
Abstract
OBJECTIVE: To identify surgical prognostic factors and to characterize clinical features according to the location of the intracranial ictal onset zone of frontal lobe epilepsy (FLE) in order to assess the role of various diagnostic modalities, including concordances with presurgical evaluations. METHODS: We studied 71 FLE patients who underwent epilepsy surgery and whose outcomes were followed for more than 2 years. Diagnoses were established by standard presurgical evaluation. RESULTS: Clinical manifestations could be categorized into six types: initial focal motor (9 patients), initial versive seizure (15), frontal lobe complex partial seizure (14), complex partial seizure mimicking temporal lobe epilepsy (18), initial tonic elevation of arms (11), and sudden secondary generalized tonic-clonic seizure (4). Thirty-seven patients became seizure-free after surgery. Five patients were deleted in the analysis because of incomplete resection of ictal onset zones. The positive predictive value of interictal EEG, ictal EEG, MRI, PET, and ictal SPECT, respectively were 62.5%, 56.4%, 73.9%, 63.2%, and 63.6%, and the negative predictive value were 46.0%, 44.4%, 53.5%, 44.7%, and 51.7%. No significant relationship was found between the diagnostic accuracy of these modalities and surgical outcome, with the exception of MRI (p=0.029). Significant concordance of two or more modalities was observed in patients who became seizure-free (p=0.011). We could not find any clinical characteristic related to surgical outcome besides seizure frequency. No definite relationship was found between the location of intracranial ictal onset zone and clinical semiology. CONCLUSION: Although various diagnostic methods can be useful in the diagnosis of FLE, only MRI can predict surgical outcome. Concordance between presurgical evaluations indicates a better surgical outcome.
ISSN
1059-1311 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18329907

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6WWW-4S1BX7Y-2-3&_cdi=7141&_user=168665&_orig=search&_coverDate=09%2F30%2F2008&_sk=999829993&view=c&wchp=dGLzVlz-zSkWz&md5=753b017fc8980b5b975d6b075cf3d495&ie=/sdarticle.pdf

http://hdl.handle.net/10371/68433
DOI
https://doi.org/10.1016/j.seizure.2008.01.007
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse