Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies.
Publication/Presentation Date
1-1-2017
Abstract
We assessed the outcome of patients with drug resistant epilepsy and neuronal antibodies who underwent epilepsy surgery. Retrospective study, information collected with a questionnaire sent to epilepsy surgery centers. Thirteen patients identified, with antibodies to GAD (8), Ma2 (2), Hu (1), LGI1 (1) or CASPR2 (1). Mean age at seizure onset: 23 years. Five patients had an encephalitic phase. Three had testicular tumors and five had autoimmune diseases. All had drug resistant temporal lobe epilepsy (median: 20 seizures/month). MRI showed unilateral temporal lobe abnormalities (mainly hippocampal sclerosis) in 9 patients, bilateral abnormalities in 3, and was normal in 1. Surgical procedures included anteromesial temporal lobectomy (10 patients), selective amygdalohippocampectomy (1), temporal pole resection (1) and radiofrequency ablation of mesial structures (1). Perivascular lymphocytic infiltrates were seen in 7/12 patients. One year outcome available in all patients, at 3 years in 9. At last visit 5/13 patients (38.5%) (with Ma2, Hu, LGI1, and 2 GAD antibodies) were in Engel's classes I or II. Epilepsy surgery may be an option for patients with drug resistant seizures associated with neuronal antibodies. Outcome seems to be worse than that expected in other etiologies, even in the presence of unilateral HS. Intracranial EEG may be required in some patients.
Volume
129
First Page
101
Last Page
105
ISSN
1872-6844
Published In/Presented At
Carreño, M., Bien, C. G., Asadi-Pooya, A. A., Sperling, M., Marusic, P., Elisak, M., Pimentel, J., Wehner, T., Mohanraj, R., Uranga, J., Gómez-Ibáñez, A., Villanueva, V., Gil, F., Donaire, A., Bargalló, N., Rumià, J., Roldán, P., Setoain, X., Pintor, L., Boget, T., … Graus, F. (2017). Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies. Epilepsy research, 129, 101–105. https://doi.org/10.1016/j.eplepsyres.2016.12.010
Disciplines
Medicine and Health Sciences
PubMedID
28043058
Department(s)
Department of Medicine
Document Type
Article