Safety and effectiveness of Insular Resections for drug-resistant Epilepsy.
Abstract number :
3.322
Submission category :
9. Surgery / 9C. All Ages
Year :
2017
Submission ID :
349639
Source :
www.aesnet.org
Presentation date :
12/4/2017 12:57:36 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Walter Hader, Foothills Medical Centre, University of Calgary, Calgary, Canada; Luis Bello-espinosa, university of calgary; Shaily Singh, university of calgary; Samuel Wiebe, university of calgary; Yahya Agha-khani, university of calgary; Yves Starreveld,
Rationale: Insular cortex involvement as a part of epileptogenic zone is often suspected in the context of operculo-insular semiology and can be confirmed by routine interrogation of the insula with stereo-electroencephalography (SEEG). However the safety and efficacy of insular resections remains unclear. Methods: We reviewed all the patients who underwent insular resection for drug-resistant epilepsy, from 2002 – 2016, in the Calgary Epilepsy Program. Details of the comprehensive pre-surgical evaluation, surgery performed, complications and seizure outcome at the latest follow-up were collected. Results: Fifteen patients (8 males, 7 females) with age range 3 – 41 years were identified. MRI was normal in 9 patients. The decision to resect the Insula was made based on clinical semiology and structural and functional imaging in 6 patients and on SEEG findings in 9 patients. Insular resection was total in 10 and partial in 5 patients. Four (26%) patients had transient hemiparesis and 1 patient had permanent mild upper extremity weakness following total resection. After a mean follow-up period of 45.6months (range 2 – 150 months), 40% of the patients are seizure free. Conclusions: Insular cortex resections for drug resistant epilepsy can be performed safely and may contribute to additional effectiveness in seizure outcomes in patients with challenging extra-temporal epilepsy. Funding: no funding received
Surgery