John Libbey Eurotext

Utility of electrocorticography in the surgical treatment of cavernomas presenting with pharmacoresistant epilepsy Volume 16, issue 3, September 2014


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1 Department of Neurophysiology, National Institute of Neurology, Neurosurgery Manuel Velasco Suárez, Mexico City
2 Medical Center ABC Santa Fe, Mexico City
3 Academy of Physiology, Institute of Biomedical Sciences of the Autonomous University of Juarez City, Chihuahua,
4 Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City
5 Comprehensive Epilepsy Center of Long Island. St. Charles Hospital, Port Jefferson, NY, USA
6 Department of Medicine and Sciences of the Health, University of Sonora, Sonora
7 Superior School of Medicine. National Polytechnic Institute, Mexico City, Mexico
* Correspondence: Dr. Daniel San-Juan Department of Neurophysiology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico

Aim. To describe the general aspects of cavernomas and epilepsy and review the available literature on the utility of electrocorticography (ECoG) in cerebral cavernoma surgery. Methods. We searched studies in PubMed, MedLine, Scopus, Web of Science, and Google Scholar (from January 1969 to December 2013) using the keywords “electrocorticography” or “ECoG” or “prognosis” or “outcome” and “cavernomas”. Original articles that reported utility of ECoG in epilepsy surgery were included. Four review authors independently selected the studies, extracted data, and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines, and Jadad Scale. A meta-analysis was not possible due to methodological, clinical, and statistical heterogeneity of included studies. We analysed six articles with a total of 219 patients. Results. The most common surgical approach was lesionectomy using ECoG in the temporal lobe with Engel I outcome range from 72.7 to 100%. Conclusions. Small controlled studies suggest that ECoG-guided resection offers the best functional results in seizure control for subjects undergoing cavernoma surgery, especially in the temporal lobe.