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Title: Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies
Author: Carreño, Mar
Bien, Christian
Asadi-Pooya, Ali A.
Sperling, Michael
Marusic, Petr
Elisak, Martin
Pimentel, Jose
Wehner, Tim
Mohanraj, Rajiv
Uranga, Juan
Gómez-Ibáñez, Asier
Villanueva, Vicente
Gil López, Francisco
Donaire Pedraza, Antonio Jesús
Bargalló Alabart, Núria​
Rumià, Jordi
Roldán, Pedro
Setoain Perego, Xavier
Pintor Pérez, Luis
Boget Llucià, Teresa
Bailles, Eva
Falip, Mercè
Aparicio, Javier
Dalmau Obrador, Josep
Graus Ribas, Francesc
Keywords: Autoanticossos
Líquid cefalorraquidi
Lòbul temporal
Cerebrospinal fluid
Drugs of abuse
Temporal lobe
Issue Date: Jan-2017
Publisher: Elsevier B.V.
Abstract: We assessed the outcome of patients with drug resistant epilepsy and neuronal antibodies who underwent epilepsy surgery. Retrospective study, information collected with a questionnaire sent to epilepsy surgery centers. Thirteen patients identified, with antibodies to GAD (8), Ma2 (2), Hu (1), LGI1 (1) or CASPR2 (1). Mean age at seizure onset: 23 years. Five patients had an encephalitic phase. Three had testicular tumors and five had autoimmune diseases. All had drug resistant temporal lobe epilepsy (median: 20 seizures/month). MRI showed unilateral temporal lobe abnormalities (mainly hippocampal sclerosis) in 9 patients, bilateral abnormalities in 3, and was normal in 1. Surgical procedures included anteromesial temporal lobectomy (10 patients), selective amygdalohippocampectomy (1), temporal pole resection (1) and radiofrequency ablation of mesial structures (1). Perivascular lymphocytic infiltrates were seen in 7/12 patients. One year outcome available in all patients, at 3 years in 9. At last visit 5/13 patients (38.5%) (with Ma2, Hu, LGI1, and 2 GAD antibodies) were in Engel's classes I or II. Epilepsy surgery may be an option for patients with drug resistant seizures associated with neuronal antibodies. Outcome seems to be worse than that expected in other etiologies, even in the presence of unilateral HS. Intracranial EEG may be required in some patients.
Note: Versió postprint del document publicat a:
It is part of: Epilepsy Research, 2017, vol. 129, p. 101-105
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ISSN: 0920-1211
Appears in Collections:Articles publicats en revistes (Medicina)

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