000 03017cam a2200313 4500500
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041 _afre
042 _adc
100 1 0 _aWang, Shuang
_eauthor
700 1 0 _a Zhang, Hongwei
_eauthor
700 1 0 _a Liu, Chang
_eauthor
700 1 0 _a Liu, Qingzhu
_eauthor
700 1 0 _a Ji, Taoyun
_eauthor
700 1 0 _a Wang, Wen
_eauthor
700 1 0 _a Yu, Guojing
_eauthor
700 1 0 _a Cai, Lixin
_eauthor
700 1 0 _a Liu, Xiaoyan
_eauthor
245 0 0 _aSurgical treatment of children with drug-resistant epilepsy involving the Rolandic area
260 _c2021.
500 _a24
520 _aObjectiveWe retrospectively analysed the clinical features and prognostic factors of surgery in children with drug-resistant epilepsy involving the Rolandic area, and the relationship between the stable compound muscle action potentials (CMAPs) of intraoperative neurophysiological monitoring (IONM) and good motor function outcomes postoperatively.MethodsA study was conducted on the clinical data of 91 patients with epilepsy who underwent epilepsy surgery involving the Rolandic area and IONM from November 2015 to February 2019.ResultsIn total, 91 patients were included in this study. The median age at seizure onset was 1.3 years old. The median age at surgery was 4.4 years old. Twenty-seven patients (29.7%), with age at onset below three years old, had epileptic spasms. The central operculum was the most common surgical region in 52 patients (57.1%). The most common pathology was focal cortical dysplasia (FCD) in 67 patients. At the last follow-up visit, 69 patients (75.8%) were seizure-free. Interictal epileptiform discharges in the Rolandic area were associated with good seizure outcome (p=0.016). Out of 91 patients, successful IONM was performed in 88 patients (96.7%). Stable CMAP was seen in 79 of 88 patients (89.8%), and irreversible disappearance of CMAP was seen in nine patients (10.2%). New permanent motor deficit was observed in 13 of 88 patients (14.8%). There was a significant correlation between stable CMAP and good motor function outcome (p<0.001).SignificanceThis is the largest reported cohort of children with drug-resistant epilepsy involving the Rolandic area who received surgery from a single centre. Epileptic spasms were only observed in young children with age at onset below three years old. The major aetiology was FCD. The rate of seizure freedom was 75.8%. Epileptiform discharges in the Rolandic area were the main prognostic factor affecting surgical outcome. Stable CMAP can predict good motor function outcome postoperatively.
690 _acompound muscle action potentials
690 _asurgery
690 _anew permanent motor deficit
690 _aintraoperative neurophysiological monitoring
690 _aRolandic area
786 0 _nEpileptic Disorders | Vol 23 | 2 | 2021-02-01 | p. 376-384 | 1294-9361
856 4 1 _uhttps://shs.cairn.info/revue-epileptic-disorders-2021-2-page-376?lang=en&redirect-ssocas=7080
999 _c611581
_d611581