Abstracts

Infantile spasm is a most common secondary generalized epileptic encephalopathy in childhood which has psychomotor developmental delay and regression. Focal cortical pathology might cause infantile spasm and It[apos]s resection might be seizure free. We evaluated surgical outcome of childhood intractable epilepsy with infantile spasms which could not find focal lesion in conventional brain MRI., We reviewed clinical characteristics of fourteen patients who could not have focal lesion in brain MRI and underwent surgical treatment from Jan. 1999 to Mar. 2006 retrospectively. We also analyzed the finding of presurgical evaluation such as FDG-PET, Video-EEG, ictal SPECT and Pathologic findings., The EEG showed focal localization in all patients, while ictal SPECT with 6 in 8 patients (75%), interictal SPECT with 5 in 11 patients (45%) and FDG-PET with 6 in 11patients (55%). We experienced single lobectomy with 10 patients (71%), multilobal resection with 4 patients (29%). Frontal lobectomy is most common in single lobectomy as 7 patients. Surgical outcome showed Engle class I in 13 patients (93%) whose pathologic findings showed cortical dysplasia with 7 patients(50%), microdysgenesis with 4 patients (29%), gliosis with one patient (7%) and normal with the others (14%)., Although patients with infantiles spasm showed no lesions in conventional MRI, Multimodal approach such as Video-EEG, FDG-PET, ictal SPECT can consider them to the epileptic surgery for the treatment.,