Localization Of Epileptogenic Zone In Cryptogenic Epilepsy And The Clinical Efficacy Analysis

Obiective:Through a retrospective analysis of the cryptogenic epilepsy，Wemade a summing up of the method location of epileptogenic focus and thepostoperative effects，so as to provide basis for the selection of surgicaltreatment and the assessment of prognosis.Methods:Twenty-six cases of the cryptogenic epilepsy treated in our hospitalfrom May2008to December2011were reviewed. Among the twenty-sixpatients, fifteen males and eleven females with an average age of25.8(range,13-56) years. The average course of disease was15.6(range,4-29) years.Seizure frequency ranging from3times/month,as many as1to3times/day. The26cases,whose CT and MRI of thehead showed no specific changes, were implanted intracranial electrodesafter a preoperative evaluation. Combined with clinical symptoms,neuroimaging, neuro-electrophysiology and neuropsychology todetermine the starting area of the epileptic foci and remove it through theoperation.Results:After a comprehensive evaluation of preoperative localization,26cases of epileptic foci can be found. Among the cases,13cases ofepileptic foci was found in the temporal lobe neocortex and medialtemporal lobe,6cases of epileptic foci was found in the surface of the frontal lobe,4cases of epileptic foci was found in the frontotemporaljunction,2cases of epileptic foci was found in the temporal lobeneocortex,1cases of epileptic foci was found in the temporal lobe andthe bottom surface of the frontal lobe.26patients were followed-up for1-5years with an average of3years. According to Engel’s classificationstandards,15cases of Engel I(11cases of epileptic foci was found in thetemporal lobe neocortex and medial temporal lobe),8cases of Engel II (2cases of epileptic foci was found in the temporal lobe neocortex andmedial temporal lobe),2cases of Engel III,1cases of Engel IV.Conclusion:When clinical symptoms, neuroimaging, neuro-electrophysiology andneuropsychology were highly consistent in localizing epileptogenic zone,we would achieve acceptable results. The epileptic foci of cryptogenicepilepsy often occur in the temporal lobe cortex and medial temporal lobe,followed by frontal surface, frontotemporal junction, temporal lobecortex,temporal lobes and frontal underside. According to Engel’sclassification standards, those cases located in the medial temporal lobeand temporal lobe obtain better effect after operation and Engel ’sclassification all better than Engel II.