PMID- 23531857
OWN - NLM
STAT- MEDLINE
DCOM- 20140113
LR  - 20130520
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 72
IP  - 6
DP  - 2013 Jun
TI  - Patients with refractory epilepsy treated using a modified multiple subpial 
      transection technique.
PG  - 890-7; discussion 897-8
LID - 10.1227/NEU.0b013e31828ba750 [doi]
AB  - BACKGROUND: : Multiple subpial transection (MST) is a potential surgical 
      treatment for patients with epileptogenic foci located in cortical areas with 
      higher functions. As neurosurgical teams have become more experienced with MST, 
      the original technique has adapted. OBJECTIVE: : To report our 6-year experience 
      with a modified MST technique. METHODS: : The population included 62 consecutive 
      patients with medically refractory epilepsy treated by MST, with a follow-up 
      period ranging from 2 to 9 years. MST was performed on gyri under neuronavigation 
      and guided by intraoperative electrocorticography. We performed radiating MST 
      from a single cortical entry point. The MST technique was described according to 
      the number of transections performed and the Brodmann areas (BAs) involved. Any 
      MST-related complications were registered and followed up. Clinical outcome was 
      described in terms of seizure suppression or reduction according to the Engel 
      modified classification. RESULTS: : Twelve patients underwent MST alone (MSTa), 
      and 50 had MST with another procedure. The main MST sites were BA 4 (61%) and 3, 
      1, 2 (58%); in 22% of cases, MST was performed in BA 44, 22, 39, and 40. 
      Permanent neurological deficits were observed in 4 (6.4%) patients; 2 minor 
      deficits were MST related (3.2%). A reduction in the seizure rate of at least 50% 
      was seen in 79% of patients (MSTa group, 75%), and 42% became seizure free (MSTa 
      group, 33%). CONCLUSION: : This study demonstrates the efficacy and low morbidity 
      of radiating MST performed under neuronavigation and intraoperative 
      electrocorticography. ABBREVIATIONS: : BA, Brodmann areaEEG, 
      electroencephalogramFDG, 18-fluorodeoxyglucoseioECoG, intraoperative 
      electrocorticographyMRE, medically refractory epilepsyMST, multiple subpial 
      transectionMSTa, multiple subpial transection aloneMST+, multiple subpial 
      transection with other procedures.
FAU - Ntsambi-Eba, Glennie
AU  - Ntsambi-Eba G
AD  - Department of Neurosurgery, Center of Refractory Epilepsy, Cliniques 
      Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium.
FAU - Vaz, Geraldo
AU  - Vaz G
FAU - Docquier, Marie-Agnes
AU  - Docquier MA
FAU - van Rijckevorsel, Kenou
AU  - van Rijckevorsel K
FAU - Raftopoulos, Christian
AU  - Raftopoulos C
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cerebral Cortex/surgery
MH  - Child
MH  - Child, Preschool
MH  - Electroencephalography
MH  - Epilepsy/*surgery
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Neuronavigation/*methods
MH  - Pia Mater/surgery
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2013/03/28 06:00
MHDA- 2014/01/15 06:00
CRDT- 2013/03/28 06:00
PHST- 2013/03/28 06:00 [entrez]
PHST- 2013/03/28 06:00 [pubmed]
PHST- 2014/01/15 06:00 [medline]
AID - 10.1227/NEU.0b013e31828ba750 [doi]
PST - ppublish
SO  - Neurosurgery. 2013 Jun;72(6):890-7; discussion 897-8. doi: 
      10.1227/NEU.0b013e31828ba750.