Turkish Neurosurgery 2014 , Vol 24 , Num 4
Combining Pyramidal Tract Mapping, Microscopic-Based Neuronavigation, and Intraoperative Magnetic Resonance Imaging Improves Outcome of Epilepsy Foci Resection in the Sensorimotor Cortex
Zhi-Qiang CUI1, Zhi-Pei LING1, Hui-Fang SONG2, Shen HU1, Guo-Chen SUN1, Xiao-Lei CHEN1, Long-Sheng PAN1, Chong LI1, Bai-Nan XU1
1Chinese PLA General Hospital, Chinese PLA Postgraduate Medical School, Department of Neurosurgery, Beijing, China
2Hebei Province Luan County People’s Hospital, Department of Neurology, Hebei Province, China
DOI : 10.5137/1019-5149.JTN.9517-13.0 AIM: 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. MATERIAL and METHODS: 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.

RESULTS: 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).

CONCLUSION: 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. Keywords : Intraoperative magnetic resonance imaging (iMRI), Microscopic-based neuronavigation, Pyramidal tract mapping, Epilepsy in the sensorimotor cortex

Corresponding author : Xu Bařnan, bnx301hos@163.com