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2017-01

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cc-by-nc-nd (c) Elsevier B.V., 2017
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/129855

Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies

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https://doi.org/10.1016/j.eplepsyres.2016.12.010

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.

Subject

Autoanticossos, Sang, Líquid cefalorraquidi, Immunologia, Epilèpsia, Drogues, Lòbul temporal, Cirurgia

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Autoantibodies, Blood, Cerebrospinal fluid, Immunology, Epilepsy, Drugs of abuse, Temporal lobe, Surgery

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citation

CARREÑO, Mar, et al. Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies. Epilepsy Research. 2017. Vol. 129, num. 101-105. ISSN 0920-1211. [consulted: 8 of August of 2026]. Available at: https://hdl.handle.net/2445/129855

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