Epilepsy Intractable, Focal Epilepsy
Conditions
Keywords
EEG-fMRI, brain imaging, presurgical evaluation, epilepsy surgery
Brief summary
The main goal of this study is to evaluate the additional value of EEG-fMRI method in the presurgical evaluation of focal intractable epilepsy. To consider a patient for surgery, the main difficulty is to define accurately the epileptogenic zone. This definition is complex and is often supported by several types of exploration (MRI, FDG PET, neuropsychological testing, video-EEG...). In this study we will evaluate the adding value of the simultaneous recording of EEG and fMRI in the epileptogenic zone definition.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* \> 8 years old * intractable focal epilepsy * presurgical evaluation or phase 1 planified * with focal EEG activity : more than 3 EEG interictal epileptic events per hour * patient and/or legal representant given their written consent for their participation in the study
Exclusion criteria
* MRI contraindication * pregnancy * uncomfortable prolonged lying position * frequent primary or secondary generalised seizure with tonic clonic movements (\>2 per week) * previous epilepsy surgery * important mental retardation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacity of surgery measured by the International League Against Epilepsy (ILAE) scale | 1 year after surgery | A score between 1-4 reflects an improvement in epilepsy and between 5-6 a lack of improvement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients who finally underwent a surgery after EEG-fMRI results even if they were considered as non surgical after standard presurgical evaluation | 1 year after surgery | — |
| Percentage of inter-ictal and ictal discharges for localizing the epileptogenic zone by EEG | 1 year after surgery | The percentage of non-localizing or lateralizing data (score 4 on the evaluation grid) will be calculated in relation to the total number of acquired victual data and compared with the equivalent percentage corresponding to the inter-state data. |
| Quality of life score (QOLIE 31) | 1 year after surgery | Comparison of the evolution of quality of life indices to 1 year of epilepsy surgery between the two groups using French versions of QOLIE 31 scales |
| Number of patients who finally underwent a surgery after EEG-fMRI results on SEEG implantation strategy after standard presurgical evaluation(concluded to a surgical management or an SEEG) | 1 year after surgery | — |
| Distinction of patients according to the type of their epilepsy: temporal / extra temporal. | 1 year after surgery | measure of the type of epilepsy effect on all the parameters studied re-evaluation of the points taking into account this distinction: main criterion, secondary criteria |
Countries
France