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Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies

M. Carreño, CG. Bien, AA. Asadi-Pooya, M. Sperling, P. Marusic, M. Elisak, J. Pimentel, T. Wehner, R. Mohanraj, J. Uranga, A. Gómez-Ibáñez, V. Villanueva, F. Gil, A. Donaire, N. Bargalló, J. Rumià, P. Roldán, X. Setoain, L. Pintor, T. Boget, E....

. 2017 ; 129 (-) : 101-105. [pub] 20161215

Jazyk angličtina Země Nizozemsko

Typ dokumentu časopisecké články, multicentrická studie, Research Support, N.I.H., Extramural, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc18010869

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.

Citace poskytuje Crossref.org

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$a We assessed the outcome of patients with drug resistant epilepsy and neuronal antibodies who underwent epilepsy surgery. Retrospective study, information collected with a questionnaire sent to epilepsy surgery centers. Thirteen patients identified, with antibodies to GAD (8), Ma2 (2), Hu (1), LGI1 (1) or CASPR2 (1). Mean age at seizure onset: 23 years. Five patients had an encephalitic phase. Three had testicular tumors and five had autoimmune diseases. All had drug resistant temporal lobe epilepsy (median: 20 seizures/month). MRI showed unilateral temporal lobe abnormalities (mainly hippocampal sclerosis) in 9 patients, bilateral abnormalities in 3, and was normal in 1. Surgical procedures included anteromesial temporal lobectomy (10 patients), selective amygdalohippocampectomy (1), temporal pole resection (1) and radiofrequency ablation of mesial structures (1). Perivascular lymphocytic infiltrates were seen in 7/12 patients. One year outcome available in all patients, at 3 years in 9. At last visit 5/13 patients (38.5%) (with Ma2, Hu, LGI1, and 2 GAD antibodies) were in Engel's classes I or II. Epilepsy surgery may be an option for patients with drug resistant seizures associated with neuronal antibodies. Outcome seems to be worse than that expected in other etiologies, even in the presence of unilateral HS. Intracranial EEG may be required in some patients.
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$a Bien, Christian G $u Epilepsy Center Bethel, Krankenhaus Mara, Bielefeld, Germany. Electronic address: christian.bien@mara.de.
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$a Asadi-Pooya, Ali A $u Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
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$a Sperling, Michael $u Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Michael.Sperling@jefferson.edu.
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$a Marusic, Petr $u Dpt. of Neurology, Charles University in Prague, 2nd Faculty of Medicine Motol University Hospital, Prague, Czechia. Electronic address: petr.marusic@fnmotol.cz.
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$a Elisak, Martin $u Dpt. of Neurology, Charles University in Prague, 2nd Faculty of Medicine Motol University Hospital, Prague, Czechia. Electronic address: martin.elisak@gmail.com.
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$a Pimentel, Jose $u Department of Neurology, Faculty of Medicine of the University of Lisbon- Hospital de Santa Maria, Lisbon, Portugal. Electronic address: josepimentel@medicina.ulisboa.pt.
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$a Wehner, Tim $u Institute of Neurology, University College London, UK. Electronic address: t.wehner@ucl.ac.uk.
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$a Mohanraj, Rajiv $u Salford Royal NHS Foundation Trust, UK. Electronic address: Rajiv.Mohanraj@srft.nhs.uk.
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$a Uranga, Juan $u Department of Neurology, Clinic of Sagrado Corazón, Sevilla, Spain. Electronic address: juanuranga@telefonica.net.
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$a Villanueva, Vicente $u Department of Neurology, Hospital la Fe, Valencia, Spain. Electronic address: vevillanuevah@yahoo.es.
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$a Gil, Francisco $u Epilepsy Unit, Department of Neurology, Hospital Clínic, Barcelona, Spain. Electronic address: fgil@clinic.ub.es.
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$a Donaire, Antonio $u Epilepsy Unit, Department of Neurology, Hospital Clínic, Barcelona, Spain. Electronic address: jdonaire@clinic.cat.
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$a Bargalló, Nuria $u Epilepsy Unit, Department of Radiology, Hospital Clínic, Barcelona, Spain. Electronic address: bargallo@clinic.cat.
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$a Rumià, Jordi $u Epilepsy Unit, Department of Neurosurgery, Hospital Clínic, Barcelona, Spain. Electronic address: jrumia@clinic.cat.
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$a Roldán, Pedro $u Epilepsy Unit, Department of Neurosurgery, Hospital Clínic, Barcelona, Spain. Electronic address: Peroldan@clinic.cat.
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$a Setoain, Xavier $u Epilepsy Unit, Department of Nuclear Medicine, Hospital Clínic, Barcelona, Spain. Electronic address: setoain@clinic.ub.es.
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$a Pintor, Luis $u Epilepsy Unit, Department of Psychiatry, Hospital Clínic, Barcelona, Spain. Electronic address: lpintor@clinic.ub.es.
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$a Boget, Teresa $u Epilepsy Unit, Department of Psychiatry, Hospital Clínic, Barcelona, Spain. Electronic address: tboget@clinic.cat.
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$a Bailles, Eva $u Epilepsy Unit, Hospital Clínic, Barcelona Spain; University Pompeu-Fabra, Barcelona, Spain. Electronic address: ebailles@gmail.com.
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$a Falip, Mercè $u Epilepsy Unit, Department of Neurology, Hospital Bellvitge, Barcelona, Spain. Electronic address: mfalip@bellvitgehospital.cat.
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$a Aparicio, Javier $u Epilepsy Unit, Department of Neurology, Hospital Clínic, Barcelona, Spain. Electronic address: japarici@clinic.ub.es.
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