Combining pyramidal tract mapping, microscopic-based neuronavigation, and intraoperative magnetic resonance imaging improves outcome of epilepsy foci resection in the sensorimotor cortex

• Published in: Turkish neurosurgery Vol. 24; no. 4; pp. 538 - 545
• Main Authors: Cui, Zhi-Qiang, Ling, Zhi-Pei, Song, Hui-Fang, Hu, Shen, Sun, Guo-Chen, Chen, Xiao-Lei, Pan, Long-Sheng, Li, Chong, Xu, Bai-Nan
• Format: Journal Article
• Language: English
• Published: Turkey 2014
• Subjects: Adolescent; Adult; Diffusion Tensor Imaging; Epilepsy - surgery; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging - methods; Male; Monitoring, Intraoperative; Nervous System Diseases - etiology; Neuronavigation - methods; Postoperative Complications - epidemiology; Pyramidal Tracts - anatomy & histology; Retrospective Studies; Sensorimotor Cortex - surgery; Treatment Outcome; Young Adult
• ISSN: 1019-5149
• DOI: 10.5137/1019-5149.JTN.9517-13.0

To explore the clinical value of combining pyramidal tract mapping, microscopic-based neuronavigation, and intraoperative magnetic resonance imaging (iMRI) in the surgical treatment of epileptic foci involving sensorimotor cortex. We retrospectively analyzed 69 patients with focal epilepsy involving motor and sensory cortex. The surgical operations in Group I (n=38) were performed under the guidance of conventional neuronavigation, and the operations of Group II (n=31) were aided by combining pyramidal tract mapping, microscopic-based neuronavigation and the iMRI technique. Chi square test was used to compare seizure outcome and neurological deficits across groups. 7 patients (18.4%) in Group I, and 3 patients (9.7%) in Group II didn't recover to the level of preoperative strength within one year post-operation. The 2-year follow-up survey showed that more patients in Group II compared to Group I (71% vs. 55.3%, p=0.181) had a good outcome (Engel class I ~ II). The techniques of combining pyramidal tract mapping, microscopic-based neuronavigation and iMRI aid in precise mapping and hence resection of epileptic foci in sensorimotor cortex, which lead to improvement of surgical efficacy and significant reduction of postoperative loss of function.