Objective To explore the clinical value of SEEG-guided radiofrequency thermocoagulation therapy in patients with posterior cortex epilepsy.Methods A case of epilepsy secondary to viral encephalitis was reported in this paper, SEEG implantation confirmed that the seizure began in bilateral posterior head, and the right posterior head was the main area of disabling lesion. After a series of complete preoperative neuropsychological assessment, the right posterior head was found to have functional retention. Therefore, we used a minimally invasive radiofrequency thermocoagulation therapy to damage epileptic foci.Results The patient were followed up for 2 years after operation, the seizure frequency were significantly reduced, and the patients did not show symptoms of functional loss.Conclusion Posterior cortex epilepsy is common in neonates with brain injury. The localization and lateralization of operation is difficult because its EEG showed bilateral discharges, or the seizures start from both sides of posterior head, meanwhile, posterior head involves functional areas, which makes the operation even more difficult. This minimally invasive treatment destroys the lesion and maximizes the protection of the patient's functional areas, which provides a new surgical approach for bilateral posterior cortex epilepsy in the future, especially for symptomatic epilepsy caused by hypoxic-ischemic brain injury and encephalitis.
Citation：
LIU Yi’ou, FENG Qian, ZHOU Wenjing. SEEG-guided radiofrequency thermocoagulation in the treatment of bilateral posterior cortex epilepsy: a case report and review of the literature. Journal of Epilepsy, 2020, 6(6): 479-484. doi: 10.7507/2096-0247.20200079
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Copyright © the editorial department of Journal of Epilepsy of West China Medical Publisher. All rights reserved
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Sierra-Marcos A, Fournier-Del Castillo MC, Álvarez-Linera J, et al. Functional surgery in pediatric drug-resistant posterior cortex epilepsy Electro-clinical findings, cognitive and seizure outcome. Seizure, 2017, 52: 46-52.
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Georgia Ramantani, Hans Holthausen. Epilepsy after cerebral infection: review of the literature and the potential for surgery. Epileptic Disord, 2017, 19(2): 117-136.
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Dave F. Clarke, Kristi Tindall, Mark Lee, et al Bilateral occipital dysplasia, seizure identification, and ablation: a novelsurgical technique. Epileptic Disord, 2014, 16(2): 238-243.
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- 1. Blume WT, Whiting SE, Girvin JP. Epilepsy surgery in the posterior cortex. Ann Neurol, 1991, 29: 638-645.
- 2. Sierra-Marcos A, Fournier-Del Castillo MC, Álvarez-Linera J, et al. Functional surgery in pediatric drug-resistant posterior cortex epilepsy Electro-clinical findings, cognitive and seizure outcome. Seizure, 2017, 52: 46-52.
- 3. Talairach J, Bancaud J, Szikla G, et al. New approach to the neurosurgery of epilepsy. Stereotaxic methodology and therapeutic results. 1. Introduction and history. Neurochirurgie, 1974, 20(Suppl 1): 1-240.
- 4. Bartolomei F, Chauvel P, Wendling F. Epileptogenicity of brain structures in human temporal lobe epilepsy: a quantified study from intracerebral EEG. Brain, 2008, 131: 1818-1830.
- 5. Aubert S, Wendling F, Regis J, et al. Localandremote epileptogenicity in focal cortical dysplasias and neurodevelopmental tumours. Brain, 2009, 132(11): 3072-3086.
- 6. Georgia Ramantani, Hans Holthausen. Epilepsy after cerebral infection: review of the literature and the potential for surgery. Epileptic Disord, 2017, 19(2): 117-136.
- 7. Dave F. Clarke, Kristi Tindall, Mark Lee, et al Bilateral occipital dysplasia, seizure identification, and ablation: a novelsurgical technique. Epileptic Disord, 2014, 16(2): 238-243.
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