Authors :
First Author: Álvaro Beltrán, MD – Hospital Ruber International
Presenting Author: Irene Sanchez-Miranda Roman, MD – Hospital Ruber Internacional, Madrid, Spain
Rafael Toledano, MD – Physician, Epilepsy Program, Department of Neurology, Hospital Ruber International; Adrián Valls, MD – Initiative for Neurosciences Foundation (Fundación Iniciativa para las Neurociencias); Marcelo Budke, MD – Department of Neurosurgery – Hospital Ruber International; Roberto martínez, MD – Department of Neurosurgery – Hospital Ruber International; irene garcía morales, MD, PhD – Epilepsy Program, Department of Neurology – Hospital Ruber International; juan Álvarez-Linera, MD – Department of Radiology – Hospital Ruber International; Paloma Parra, MD – Physician, Epilepsy Program, Department of Neurology, Hospital Ruber International; Irene Sánchez-Miranda, MD – Epilepsy Program, Department of Neurology – Hospital Ruber International; Antonio gil-Nagel, MD, PhD – Head of Department, Epilepsy Program, Department of Neurology, Hospital Ruber International
Rationale: Stereo-EEG-guided thermocoagulation (TC) is an alternative for the treatment of focal refractory epilepsy (FRE).
1 This study describes the safety and effectivity of this technique in a tertiary care center.
Methods: Retrospective observational study including patients diagnosed with FRE who underwent stereo-EEG and TC between 2012 and 2021 in a tertiary care center. Those with a reduction of 50% or more in seizure frequency were considered as responders at months two and twelve. Those who underwent epilepsy surgery between months two and twelve were considered as non-responders.
Results: Fifty-two patients and 56 procedures of TC were included (median age 24.3 years-old). Fifty percent displayed a non-lesional brain MRI, 32.1% had a large lesion, and 17.9% a circumscribed lesion. The implantation was extra-temporal in 78.6%. TC was carried out in a median of 17 contacts per patient. Thirty-nine percent were responders, and 17.9% were seizure-free at 12 months. The percentage of seizure-freedom at two months was significantly higher among patients displaying circumscribed lesions (p < 0.001). Among patients who finally underwent epilepsy surgery, being responder at two months was significantly associated to a higher probability of Engel I at 12 months after surgery (positive predictive value 0.62). No severe TC-related adverse events were notified.