Supervisor：Ministry of Education of the People's Republic of ChinaSponsor：Sichuan University Editor-in-chief：ZHOU DONG Publishing period：
Bimonthly
ISSN：2096-0247CN：51-1762/R
The application research of Magnetoencephalograph, Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia
Objective
To investigate the application of Magnetoencephalograph (MEG), Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia (FCD ).
Methods
The epileptogenic focus and IQ, memory and language examination were performed in 34 patients with frontal and temporal epilepsy caused by FCD. MEG and Wada test were conducted to determine the language and memory advantage hemisphere, and to clarify the scope and memory function of language function areas. Operation was guided by the Medtronic stealhealth 7 surgical navigation system (USA) to remove the FCD and protect nerve function. IQ, memory and language examination were measured 1 year after operation, and the difference was observed before and after operation. The postoperative follow-up was 23 ~ 46 months, curative effect of epilepsy was determined according to the international anti-epilepsy union Engel’s standard.
Results
Thirty-four patients with epilepsy (21 temporal lobe epilepsy and 13 frontal lobe epilepsy) were included in this study. The examination process of MEG and Wada test was smooth. MEG can accurately locate the position of language function area. Twenty-eight patients’ dominant hemisphere of language was on the left and 6 was on the right side. Wada test can evaluate the patient’s memory function. Twenty-three patients’ dominant hemisphere of memory was located on the left, 8 on the right and 3 on the bilateral hemisphere. Compared with the dominant hemisphere and nondominant hemisphere, the memory score was significantly different (P<0.05). Statistics showed that the verbal IQ and total IQ increased (P<0.05)1 year after operation, but there was no significant change in memory IQ and Performance IQ (P>0.05). FCD patients recovered well without language, memory and limb impairment. The curative effect of epilepsy: 15 cases of Engel’sⅠgrade, 14 cases of Engel’sⅡgrade and 5 cases of Engel’s Ⅲ grade.
Conclusion
MEG, Wada test combined with neuronavigation was of important value in locating and guiding the surgical resection of FCD in patients with refractory frontal and temporal epilepsy, protecting cortical function, avoiding severe postoperative complications, and improving the therapeutic effect of epilepsy.
Citation：GUO Tao, GUO Fei, WU Jiang, YUE Xiangyong. The application research of Magnetoencephalograph, Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia. Journal of Epilepsy, 2018, 4(1): 18-23. doi: 10.7507/2096-0247.20180005Copy
Copyright ? the editorial department of Journal of Epilepsy of West China Medical Publisher. All rights reserved
Perucca E. Optimizing antiepileptic drug treatment in tumoral epilepsy. Epilepsia, 2013, 54(Suppl 9): 97-104.
3.
Verrotti A, D’Egidio C, Agostinelli S, et al. Antiepileptic drug withdrawal in childhood epilepsy: what are the risk factors associated with seizure relapse?. Eur J Paediatr Neurol, 2012, 16(6): 599-604.
Deling L, Nan J, Yongji T, et al. Intraventricular ganglioglioma prognosis and hydrocephalus: the largest case series and systematic literature review. Acta Neurochir (Wien), 2013, 155(7): 1253-1260.
Passarelli V, Pinto LF, Jorge CL, et al. The intracarotid etomidate Wada test: A 54-patient series. Epilepsy Behav, 2014, 39: 73-77.
8.
Jehi LE, Palmini A, Aryal U, et al. Cerebral cavernous malformations in the setting of focal epilepsies: pathological findings, clinical characteristics, and surgical treatment principles. Acta Neuropathol, 2014, 128(1): 55-65.
9.
Kumar A, Chandra PS, Sharma BS, et al. The role of neuronavigation-guided functional MRI and diffusion tensor tractography along with cortical stimulation in patients with eloquent cortex lesions. Br J Neurosurg, 2014, 28(2): 226-233.
10.
Curot J, Denuelle M, Busigny T, et al. Bilateral Wada test: amobarbital or propofol?. Seizure, 2014, 23(2): 122-128.
11.
Bauer PR, Reitsma JB, Houweling BM, et al. Can fMRI safely replace the Wada test for preoperative assessment of language lateralisation? A meta-analysis and systematic review. J Neurol Neurosurg Psychiatry, 2014, 85(5): 581-588.
12.
Campos BM, Coan AC, Beltramini GC, et al. White matter abnormalities associate with type and localization of focal epileptogenic lesions. Epilepsia, 2015, 56(1): 125-132.
Papanicolaou AC, Simos PG, Castillo EM, et al. Magnetocephalography: a noninvasive alternative to the Wada procedure. J Neurosurg, 2004, 100(5): 867-876.
2. Perucca E. Optimizing antiepileptic drug treatment in tumoral epilepsy. Epilepsia, 2013, 54(Suppl 9): 97-104.
3. Verrotti A, D’Egidio C, Agostinelli S, et al. Antiepileptic drug withdrawal in childhood epilepsy: what are the risk factors associated with seizure relapse?. Eur J Paediatr Neurol, 2012, 16(6): 599-604.
5. Deling L, Nan J, Yongji T, et al. Intraventricular ganglioglioma prognosis and hydrocephalus: the largest case series and systematic literature review. Acta Neurochir (Wien), 2013, 155(7): 1253-1260.
7. Passarelli V, Pinto LF, Jorge CL, et al. The intracarotid etomidate Wada test: A 54-patient series. Epilepsy Behav, 2014, 39: 73-77.
8. Jehi LE, Palmini A, Aryal U, et al. Cerebral cavernous malformations in the setting of focal epilepsies: pathological findings, clinical characteristics, and surgical treatment principles. Acta Neuropathol, 2014, 128(1): 55-65.
9. Kumar A, Chandra PS, Sharma BS, et al. The role of neuronavigation-guided functional MRI and diffusion tensor tractography along with cortical stimulation in patients with eloquent cortex lesions. Br J Neurosurg, 2014, 28(2): 226-233.
10. Curot J, Denuelle M, Busigny T, et al. Bilateral Wada test: amobarbital or propofol?. Seizure, 2014, 23(2): 122-128.
11. Bauer PR, Reitsma JB, Houweling BM, et al. Can fMRI safely replace the Wada test for preoperative assessment of language lateralisation? A meta-analysis and systematic review. J Neurol Neurosurg Psychiatry, 2014, 85(5): 581-588.
12. Campos BM, Coan AC, Beltramini GC, et al. White matter abnormalities associate with type and localization of focal epileptogenic lesions. Epilepsia, 2015, 56(1): 125-132.
14. Papanicolaou AC, Simos PG, Castillo EM, et al. Magnetocephalography: a noninvasive alternative to the Wada procedure. J Neurosurg, 2004, 100(5): 867-876.
Click the content below to copy and paste a set citation format。
Citation：GUO Tao, GUO Fei, WU Jiang, YUE Xiangyong. The application research of Magnetoencephalograph, Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia. Journal of Epilepsy, 2018, 4(1): 18-23. doi: 10.7507/2096-0247.20180005
1/5
WeChat