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The causal epileptic network identifies the primary epileptogenic zone in Lennox-Gastaut syndrome

Authors
 Yun Jung Hur  ;  Heung Dong Kim 
Citation
 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, Vol.33 : 1-7, 2015 
Journal Title
 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 
ISSN
 1059-1311 
Issue Date
2015
MeSH
Adolescent ; Automatic Data Processing ; Brain Mapping* ; Brain Waves/physiology* ; Child ; Electroencephalography ; Female ; Humans ; Lennox Gastaut Syndrome/pathology* ; Lennox Gastaut Syndrome/physiopathology* ; Magnetic Resonance Imaging ; Male ; Video Recording ; Young Adult
Keywords
Direct directed transfer function ; Generalized sharp and wave discharge ; Lennox–Gastaut syndrome ; Resective surgery
Abstract
PURPOSE: Lennox-Gastaut syndrome (LGS) can be successfully treated by resective surgery in patients with a primary epileptogenic zone. This study aimed to identify the primary epileptogenic zone based on the causal epileptic network using direct directed transfer function (dDTF) analysis. METHODS: We reviewed the dDTF findings for generalized sharp and wave discharges (GSW) from the preoperative electroencephalography (EEG) of 12 LGS patients (group A) with unilateral focal pathology who were successfully treated with resective surgery. These findings were compared with preoperative dDTF findings for the GSW from 15 LGS patients with bilateral non-resectable pathology (group B) who exhibited persistent bilateral independent diffuse sharp and wave discharges, even after corpus callosotomy. RESULTS: The dDTF analysis of the GSW revealed concordant findings of localization or lateralization with the primary epileptogenic zone in 83.3% (10/12 cases) of group A patients and bilateral or multifocal localization in 93.3% (14/15) of group B patients (p<0.01). The regions identified by dDTF analysis were included in the resected areas of all patients in group A, and complete matches of the resected areas without other foci were observed in 7 patients (58.3%) in group A. The region of GSW most frequently identified by dDTF analysis was the frontal area, which was identified in 91.7% (11/12) of group A and in 100% of group B, while extra-frontal areas were identified in 36.1% and 24.5% of groups A and B, respectively. CONCLUSIONS: The dDTF analysis of GSW could provide additional information to identify resective surgery candidates for patients with LGS.
Files in This Item:
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DOI
10.1016/j.seizure.2015.10.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157152
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