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Electroencephalography features of primary epileptogenic regions in surgically treated MRI-negative infantile spasms.

 Hur Y.J.  ;  Lee J.S.  ;  Kim D.S.  ;  Hwang T.  ;  Kim H.D. 
 PEDIATRIC NEUROSURGERY, Vol.46(3) : 182-187, 2010 
Journal Title
Issue Date
Child ; Child, Preschool ; Electroencephalography* ; Female ; Frontal Lobe/surgery* ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Neurosurgical Procedures/methods ; Positron-Emission Tomography ; Postoperative Complications/diagnosis ; Prognosis ; Retrospective Studies ; Spasms, Infantile/classification ; Spasms, Infantile/diagnosis* ; Spasms, Infantile/surgery* ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome
Infantile spasms ; Epileptogenic regions ; Electroencephalography
OBJECTIVE: To evaluate the surgical outcome for intractable, MRI-negative infantile spasms (IS), and to identify diagnostic targets in the focal epileptogenic area by methods other than MRI. METHODS: We retrospectively studied 9 patients who had had surgery for intractable IS, and whose lesions did not appear on MRI. We analyzed video/electroencephalography (EEG), single photon emission computed tomography (SPECT) and positron emission tomography (PET) findings and their surgical outcomes. In 7 patients who were seizure free after surgery, we analyzed the EEG parameters for characteristics expected in the primary epileptogenic region. RESULTS: All patients underwent resective surgery including frontal lobectomy and multilobar resection. Seven patients showed an Engel class I outcome, and 2 patients showed a class III outcome. Interictal SPECT results showed 66.7% concordance for the hemisphere affected (lateralization), and 55.6% for lesion location (localization). Ictal SPECT showed 71.4% concordance for lateralization and localization. PET showed 66.7% concordance for lateralization, and 55.6% for localization. EEG parameters, including localized paroxysmal fast activities, spindle-shaped fast activities, repetitive or rhythmic sharp/spike wave discharges, and subclinical seizures showed highly localized specificity, and may serve to identify the epileptogenic lesion. CONCLUSION: Surgical treatment of MRI-negative IS should be justified using a combination of diagnostic methods
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
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