Clinical Article
Preliminary observation of epileptogenic zonectomy in the treatment of epilepsy arising from supplementary motor area
Ni Duanyu, Wang Xueyuan, Qiao Liang, Yan Hao, Yu Tao, Xu Cuiping, Piao Yuanyuan, He Liu, Zhang Guojun, Zhang Xiaohua
Published 2022-05-28
Cite as Chin J Neurosurg, 2022, 38(5): 471-475. DOI: 10.3760/cma.j.cn112050-20210611-00281
Abstract
ObjectiveTo preliminarily observe the efficacy and postoperative complications of epileptogenic zonectomy in the treatment of epilepsy arising from supplementary motor area (SMA).
MethodsA retrospective analysis was conducted on the clinical data of 9 patients with SMA epilepsy admitted to the Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University from June 2015 to December 2020. In all 9 patients, their seizures were confirmed by stereotactic electroencephalography (SEEG) to originate from SMA, and they underwent epileptogenic zonectomy. All patients underwent daily examinations of limb muscle strength, muscle tone and language function (comprehension, reading, repetition, etc.) during the postoperative hospital stay. Outpatient follow-up was performed at 1, 3, 6, 12 and 24 months after operation, and electroencephalography was performed. The postoperative outcome was evaluated according to the modified Engel grading system.
ResultsAmong the 9 patients, 5 underwent epileptogenic zonectomy in the left hemisphere and 4 in the right hemisphere. The resected area included ipsilateral SMA. Postoperative pathological examination revealed focal cortical dysplasia in all cases. After operation, 8 patients reached seizure free, and 1 patient reported occasional short periods of loss of consciousness. Nine patients had different degrees of limb movement impairment, and all returned to normal one month after surgery. Four patients had language dysfunction, out of whom 1 patient recovered 7 days after surgery and 3 returned to normal 1 month after operation. The median follow-up time of 9 patients was 3 years (1-5 years). At the last follow-up, 8 cases were classified as Ⅰa and 1 case as Ⅰb according to the modified Engel grading system.
ConclusionPreliminary observation has suggested that epileptogenic zonectomy for patients with epilepsy originating from SMA has good long-term efficacy. Although SMA syndrome often occurs after surgery, patients would recover within 1 month after surgery.
Key words:
Epilepsy; Neurosurgical procedures; Treatment outcome; Supplementary motor area
Contributor Information
Ni Duanyu
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Wang Xueyuan
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Qiao Liang
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Yan Hao
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Yu Tao
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Xu Cuiping
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Piao Yuanyuan
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
He Liu
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Zhang Guojun
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Zhang Xiaohua
Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
