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B.03 Safety and effectiveness of insular resections for drug-resistant epilepsy

Published online by Cambridge University Press:  02 June 2017

S Vuddagiri
Affiliation:
(calgary)
L Bello-Espinosa
Affiliation:
(calgary)
S Singh
Affiliation:
(calgary)
S Wiebe
Affiliation:
(calgary)
Y Agha-khani
Affiliation:
(calgary)
S Yves
Affiliation:
(calgary)
H Walter
Affiliation:
(calgary)
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Abstract

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Background: Insular cortex involvement as a part of epileptogenic zone is often suspected in the context of operculo-insular semiology and can be confirmed by routine interrogation of the insula with stereo-electroencephalography (SEEG). However the safety and efficacy of insular resections remains unclear. Methods: We reviewed all the patients who underwent insular resection for drug-resistant epilepsy, from 2002 – 2016, in the Calgary Epilepsy Program. Details of the comprehensive pre-surgical evaluation, surgery performed, complications and seizure outcome at the latest follow-up were collected. Results: Fifteen patients (8 males, 7 females) with age range 3 – 41 years were identified. MRI was normal in 9 patients. The decision to resect the Insula was made based on clinical semiology and structural and functional imaging in 6 patients and on SEEG findings in 9 patients. Insular resection was total in 11 and partial in 4 patients. Four (26%) patients had transient hemiparesis and 1 patient had permanent mild upper extremity weakness following total resection. After a mean follow-up period of 45.6 months (range 2 – 150 months), 40% of the patients are seizure free. Conclusions: Insular cortex resections for drug resistant epilepsy can be performed safely and may contribute to additional effectiveness in seizure outcomes in patients with challenging extra-temporal epilepsy.

Type
Platform Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2017