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J Korean Neurol Assoc. 1999;17(5):645-650.
- Intractable Epilepsy associated with Neurocysticercosis :
Perilesional Epileptogenic Features
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Soo Jin Yoon, Dae Won Seo, Seung Bong Hong, Seung Chul Hong*, Yeon-Lim Suh**,
Kwang Ho Lee, Won Yong Lee, Byoung Joon Kim
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Departments of Neurology, Neurosurgery*, and Diagnostic Pathology**
Samsung Medical Center, Sungkyunkwan University School of Medicine
- 뇌낭미충증으로 인한 난치성 간질에서
병변 주변의 간질 생성 소견
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윤수진, 서대원 홍승봉 홍승철*서연림**이광호 이원용 김병준
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성균관대학교 의과대학 삼성서울병원 신경과,신경외과*,진단병리과**
- Abstract
- Background
: Neurocysticercosis (NCC) is the most common parasitic disease of the CNS and seizures are the most
frequent clinical manifestations of it. Although the medical treatment of NCC is effective, epilepsy surgery is still need-ed
to treat refractory seizures. We investigated five cases with refractory seizures due to NCC to verify perilesional
epileptogenic changes in NCC. Methods : We included 5 intractable epilepsy patients who had epilepsy surgery and
pathologically proven cysticercosis although serological tests were negative. A routine EEG and brain MRI were per-formed
in all patients. Video scalp-EEG monitorings were done in 5 patients, including an invasive-EEG monitoring in
one. We analyzed the relationships between semiology, brain MRI, interictal, and ictal EEG findings, pathologic fea-tures
and surgical outcomes. Results : All patients had abdominal or psychic aura, evolving into automotor seizure and
then secondarily generalized tonic clonic seizures. Two patients often had only the aura. In brain MRI, four patients
had showed NCC lesions in the mesial temporal area, and one had it in the basal occipital area. Hippocampal atrophy
was also detected in 3 patients. Irritative and ictal onset zones on an EEG were located around the lesions. Pathologic
findings confirmed hippocampal sclerosis in 3 patients and coritcal dyslamination and many single heterotopic neurons
in the temporal lobe in 1 patient. Surgical outcomes showed 3 patients in class IA, 1 in class IC, and 1 in class IIB by
Engel classification. Conclusions : Epileptic foci could be formed focally around the NCC lesion and hippocampal
sclerosis frequently accompanied when the lesion was located near the mesial temporal structures. After verifying
epileptic foci and lesion, epilepsy surgery had good surgical outcome.
J Kor Neurol Ass 17(5):645~650, 1999
Key Words : Neurocysticercosis, Hippocampal atrophy, Intractable epilepsy, EEG monitoring, Epilepsy surgery
Keywords :
- 초록
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