Preoperative Localization Evaluation Of Epileptogenic Zone In Children

Objective: by analysising13cases of preoperative evaluation results inchildren with epilepsy, to summarize the significance and effect of differentmethods in EZ localization. studying preoperative evaluation strategies forchildren with epilepsy, to provide theoretical basis for seting up standardand operation specification of children’s EZ localization.Methods: Collecting13cases of preoperative evaluation in childrenwith epilepsy in the department of neurology ward at Children’s Hospital ofChongqing Medical University from January,2012to March,2013.According to the preoperative staging comprehensive assessment ofepilepsy surgery, as, stageⅠ-non invasive examination, stage Ⅱ-invasiveexamination, and multidisciplinary preoperative discussion. To compare thevalue of preoperative localization of epilepsy semeiology, scalp VEEG, headMRI, PET-CT, head fMRI in children with epilepsy, by usingcomprehensive assessment, cortical EEG, and operative results as thestandard.Results:(1) after preoperative evaluation of13cases of children with epilepsy,7 cases haveu nderwent surgery treatment,1case plan to have surgicaltreatment,5cases are not suitable for surgical treatment temporarily.(2) in8cases of children with epilepsy suitable for surgical treatment,there are4cases used cortical EEG monitoring. The similitude ratio ofsemeiology, scalp VEEG, MRI, PET-CT, fMRI results with cortical EEG is2/4,3/4,3/4,4/4,2/4, respectively.(3)in7cases of children who have underwent epilepsy surgery, thesimilitude ratio of semeiology, scalp VEEG, MRI, PET-CT, fMRI resultswith cortical EEG is2/7,5/7,6/7,7/7,5/7, respectively.(4) the postoperative pathology of7cases children underwent epilepsysurgery, respectively are: Focal cortical dysplasia; Focal cortical dysplasiawith vascular malformation, gray matter heterotopia; Focal corticaldysplasia with dysembryoplastic neuroepithelial tumor; Focal corticaldysplasia with hippocampal sclerosis; oligodendrocytes tumor;Transitional type meningioma; Tumorlike masses of demyelination.6casesof children follow-up1to14months, postoperative, no seizures and functiondamage;1case of patients lost to follow-up.Conclusions:There are many ways to position EZ before surgery, and how to usethem legitimately in clinical is a problem. Neither overtesting, lead towaste of medical resources; nor positioning EZ with only one, or a few ofitems simply. Using EEG can diagnose, classify, and position most patient with epilepsy. But the ultimately positioning of EZ and function zone, needto combine EEG with symptomatology, neuroimaging, functional imaging,and neuropsychological tests, etc.