APPLICATION OF THE METHOD OF MULTIPLE SUBPIAL TRANSSECTION IN SURGICAL TRETMENT FOCAL CYSTIC ARACHNOIDITIS OF THE BRAIN WITH EPILEPTIC SYNDROME
Abstract
Focal cystic-arachnoiditis of the brain (FCAB) - is a relatively rare pathology of the brain in most cases accompanied with the prominent drug treatment resistant epileptic activity (16-60% of cases). Possibilities o f treatment tactics and methods of influence to the epileptic focus optimization were studied on 92 patients with FSAB. After evaluation of the treatments results in all three groups it was found that there was a significant prevalence of positive results in a group of patients who underwent multiple subpial transsection (MST), where elimination of epileptic seizu(62,5% of cases) and solitary epileptic episodes during postoperative period were observed in 9 patients (20,1% cases in this group). Complete elimination of seizures was archived only in 13,3% and 16,7% of cases in groups of patients that were operated without MST and received drug treatment respectively. Next conclusions were made: MST is an effective and safe method of treatment of the focal paroxysmal activity in FCAB; this method can be recommended to this type of patients as a method of choice.
Keywords:
cystic arachnoiditis, surgical treatment of epilepsy, multiple subpial transsectionReferences
1. Боровикова В.Н., Рябуха Н.П., Юхарев С. П. Усовершенствование методики электрокортикографии при одномоментных и долгосрочных стереотаксических вмешательствах // Журн. Вопр. Нейрохирургии им. Бурденко. - 1995. - Вып. 3. - С. 38-40.
2. Добровольский Г.Ф., Вихерг Г.М., Ивакина Н.И., Никулина Л.А. Арахноидальные кисты (патоморгологические исследования). // Журн. Невропатол. И псих. Им. Корсакова. - 1990. - Т.90, №10. -С.20-25.
3. Кушель Ю. . Арахноидальные кисты головного мозга Частные вопросы детской нейрохирургии Невронет 2002г.
4. Мелекян А.Г., Озерова П.И., Брагина Н.Н., Колычева М.В. Эндоскопическая фенестрация срединныхсупратенториальных ликворных кист. // Вопросы нейрохирургии. - 1999г., №4 - С. 7-13.
5. Arroyo S. Santamaria J. What is the relationship between arachnoid cysts and seizure foci? [see com- mentsj.Epilepsia. 38(10): 1098-102, 1997 Oct.
6. Di Rocco C. Arachnoid cysts // Neurological Surgery 1996.-V.-2.-P.967-994.
7. Gangemi М., M.D., F. Maiuri, M.D., G. Colella, M.D., and L. Sardo, M.D. Endoscopic surgery for intracranial cerebrospinal fluid cyst malformations Neurosurg Focus 6 (4):Article 6, 1999
8. Hufnagel A. Zentner J. Fernandez G. Wolf HK. Schramm J. Eiger CE. Multiple subpial transection for control of epileptic seizures: effectiveness and safety. Epilepsia. 38(6):678-88, 1997 Jun.
9. Kobayashi Eliane; Leonardo Bonilha; Li M. Li; Fernando Cendes Temporal lobe hypogenesis associated with arachnoid cyst in patients with epilepsy Arq. Neuro- Psiquiatr. vol.61 no.2B Sao Paulo June 2003
10. Koch CA. Arachnoid cyst and epilepsy [letter; comment]. Surgical Neurology. 51(6):687-8, 1999 Jun.
11. Koch CA. Moore JL. Voth D. Arachnoid cysts: how do postsurgical cyst size and seizure outcome correlate? Neurosurgical Review. 21(l):14-22, 1998.
12. Kim MH. The role of endoscopic fenestration procedures for cerebral arachnoid cysts. Journal of Korean Medical Science. 14(4):443-7, 1999 Aug.
13. Mazurkiewicz-Beldzinska Maria, , Dilling- Ostrowska Ewa Presentation of intracranial arachnoid cysts in children:correlation between localization and clinical symptoms. Med Sci Monit,2002;8(6):CR462-465
14. Morrell F, Whisler WW, Bleck TP. Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. Neurosurg 1989 Feb;70(2):231-9
15. Rengachary S.S. Kenntdy J. D. Intracranial arachnoid and ependymal cysts // Neurosurgery. - 1996. -V.3.-P. 3709-3728
16. Rougier A. Sundstrom L. Claverie B. Saint-Hilaire JM. Labrecque R. Lurton D. Bouvier G. Multiple subpial transection: report of 7 cases. Epilepsy Research. 24(1 ):57- 63, 1996 May.
17. Shapiro N.K. Swift M.D. Intracranial arachnoid cysts // The practice of Neurosurgery. 1996. - V.-3. P.- 2668-2679.
18. Vaquerizo-Madrid J. Sylvian arachnoid cysts, temporal lobe hypoplasia and epileptic encephalopathy. Revista de Neurologia. 29(12):1188-9, 1999 Dec 16-31.
