Premium
Surgical Resection for Intractable Epilepsy in “Double Cortex” Syndrome Yields Inadequate Results
Author(s) -
Bernasconi A.,
Martinez V.,
RosaNeto P.,
D'Agostino D.,
Bernasconi N.,
Berkovic S.,
MacKay M.,
Harvey A. Simon,
Palmini A.,
Da Costa J. Costa,
Paglioli Eliseu,
Kim H.I.,
Connolly M.,
Olivier A.,
Dubeau F.,
Andermann E.,
Guerrini R.,
Whisler W.,
De ToledoMorrell L.,
Morrell F.,
Andermann F.
Publication year - 2001
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2001.39900.x
Subject(s) - corpus callosotomy , epilepsy , stereoelectroencephalography , epilepsy surgery , magnetic resonance imaging , medicine , temporal lobe , electroencephalography , frontal lobe , intractable epilepsy , cortex (anatomy) , anterior temporal lobectomy , surgery , psychology , radiology , neuroscience
Summary: Purpose: To analyze the results of surgical treatment of intractable epilepsy in patients with subcortical band heterotopia, or double cortex syndrome, a diffuse neuronal migration disorder. Methods: We studied eight patients (five women) with double cortex syndrome and intractable epilepsy. All had a comprehensive presurgical evaluation including prolonged video‐EEG recordings and magnetic resonance imaging (MRI). Results: All patients had partial seizures, with secondary generalization in six of them. Neurologic examination was normal in all. Three were of normal intelligence, and five were mildly retarded. Six patients underwent invasive EEG recordings, three of them with subdural grids and three with stereotactic implanted depth electrodes (SEEG). Although EEG recordings showed multilobar epileptic abnormalities in most patients, regional or focal seizure onset was recorded in all. MRI showed bilateral subcortical band heterotopia, asymmetric in thickness in three. An additional area of cortical thickening in the left frontal lobe was found in one patient. Surgical procedures included multiple subpial transections in two patients, frontal lesionectomy in one, temporal lobectomy with amygdalohippocampectomy in five, and an additional anterior callosotomy in one. Five patients had no significant improvement, two had some improvement, and one was greatly improved. Conclusion: Our results do not support focal surgical removal of epileptogenic tissue in patients with double cortex syndrome, even in the presence of a relatively localized epileptogenic area.