Rolandic cortex surgery ‘can be effective means of epilepsy treatment’
A new study from Germany has underlined the benefits associated with epilepsy surgery of the rolandic and immediate perirolandic cortex, as well as the potential risks of this treatment approach.
Conducted by the University of Bonn, the research comprised a single-centre retrospective study of patients who underwent epilepsy surgery for seizures arising from the rolandic or sensorimotor cortex – a part of the brain controlling sense and movement functions.
Aiming to evaluate both surgical and neurologic outcomes of this technique, while also identifying prognostic factors associated with better seizure outcome, the researchers looked at data from a total of 66 patients who had undergone different surgical treatment techniques.
Results published in the journal Epilepsia revealed that favourable postoperative seizure outcomes were achieved in 64 per cent of the patients who underwent surgery. Of the 42 who were treated successfully, 39 were shown to be completely seizure-free.
The odds of a favourable seizure outcome in the group undergoing resections within their rolandic cortex was shown to be better, at 72 per cent, than in the group with resections in immediate perirolandic cortex and simultaneous sensorimotor multiple subpial transections, of whom 45 per cent were successfully treated.
However, it was also noted that 34 per cent of patients experienced a postoperative permanent neurologic deficit.
Independent predictors for excellent seizure outcome after multivariate regression analysis included complete resection of the lesion, disease pathology, age at surgery and the absence of preoperative simple partial seizures.
The researchers concluded: “The increased risk for postoperative neurologic deficits is higher than in other locations, and this must be discussed with patients in detail prior to surgery. Best postoperative results can be achieved in cases in which a complete resection is possible without damaging eloquent cortical areas.”
Since antiepileptic drugs are effective in treating only 70 per cent of cases of epilepsy, many patients often undergo surgery as a means of controlling their seizures, often with successful results.
Posted by Anne Brown