Clinical Study

Surgical Treatment of Patients with Lennox-Gastaut Syndrome Phenotype

Table 1

Patient profiles—number 1.

NumberAge at surgery (years)Duration of seizure at surgery (years)Drug resistant time (years)EtiologySeizure typeEEG (characteristic and dominant locations)MRISPECT

1532.2Hypoxic ischemic insultTonic + atonic + atypical absence + SPSSSW + PFA, rt.sz (frontal + temporal + occipital)Focal atrophy (rt. frontal)

2763Head injury (previous CT scan shows subarachnoid hemorrhage)Tonic + myoclonic + GTCS + atypical absenceSSW + PFA, lt.sz (frontal + temporal + parietal + occipital)NormalInterictal hypoperfusion and ictal hyperperfusion (lt. temporal + occipital)

312109Brain atrophy (determined by MRI)Tonic + atonic + absence + SPSSSW + PFA, lt.sz (frontal + temporal + parietal)lt. hemisphere atrophyInterictal hypoperfusion (lt. frontal + temporal)

462.91.8Cortical dysplasiaTonic + GTCS + SPSSSW + PFA, rt. Sz (temporal)Focal cortical dysplasia (rt. temporal)

572.82.6Head injury (previous CT scan shows mild brain contusion)Tonic + myoclonic + GTCSSSW + PFA, lt.sz. (frontal + temporal + parietal)Normal

6942.5Hypoxic ischemic insultMyoclonic + GTCS + atypical absence + CPSSSW + PFA, rt.sz (frontal + temporal + occipital)rt. hemisphere atrophyInterictal hypoperfusion and ictal hyperperfusion (rt. frontal + occipital)

761.91.4Cortical dysplasiaTonic + atypical absence + SPSSSW + PFA, lt.sz (frontal)Focal cortical dysplasia (lt. frontal)

81065Hypoxic ischemic insultTonic + atonic + atypical absence + CPSSSW + PFA, rt.sz (frontal + temporal + parietal + occipital)rt. hemisphere atrophyInterictal hypoperfusion (rt. parietal + temporal)

9966Vascular malformationTonic + CPSSSW + PFA, lt.sz (parietal)small vascular malformation (lt parietal)Interictal normal

101399Brain atrophy (determined by MRI)Tonic + myoclonic + atypical absence + GTCSSSW + PFA, rt.sz. (parietal + occipital)focal atrophy (rt parietal)Interictal hypoperfusion and ictal hyperperfusion (rt. occipital)

11966Vascular malformationTonic + myoclonic + CPSSSW + PFA, lt.sz. (frontal + temporal + parietal)Vascular malformation (lt parietal)Interictal hypoperfusion and ictal hyperperfusion (lt. temporal + parietal)

121187EncephalitisTonic + atypical absence + GTCS + CPSSSW + PFA, lt.sz. (parietal + occipital)NormalInterictal hypoperfusion and ictal hyperperfusion (lt. temporal)

13843Brain atrophy (determined by MRI)Tonic + myoclonic + atypical absenceSSW + PFA, lt.sz. (frontal + parietal + occipital)lt. focal atrophy (lt frontal)

141374Tuberous sclerosisMyoclonic + GTCS + atypical absence + SPSSSW + PFA, It.sz (temporal + occipital)Cortex tubers and subependymal nodulesInterictal hypoperfusion and ictal hyperperfusion (rt. frontal and lt occipital)

15171615EncephalitisTonic + atonic + GTCS + CPSSSW + PFA, rt.sz (frontal + temporal + parietal)NormalInterictal hypoperfusion and ictal hyperperfusion (rt. frontal)

16242119Hypoxic ischemic insultTonic + myoclonic + GTCS + SPSSSW + PFA, lt.sz (frontal temporal + parietal)lt. focal atrophy and perforating ventricle malformationInterictal hypoperfusion (lt. temporal), and no change in ictal SPECT

17191515Brain atrophy (determined by MRI)Tonic + atypical absence + GTCS + CPSSSW, rt.sz. (temporal + parietal)rt. hemisphere atrophy and HSInterictal hypoperfusion and ictal hyperperfusion (rt. temporal)

18221612Brain atrophy (determined by MRI)Tonic + atypical absence + atonic + CPSSSW + PFA, lt.sz. (frontal + temporal + parietal)lt. HS and focal atrophy (temporal)Interictal hypoperfusion (lt. frontal + temporal)

Abbreviations: CPS: complex partial seizure; EEG: electroencephalogram; HS: hippocampal sclerosis; GTCS: generalized tonic-clonic seizures; LGS: Lennox-Gastaut syndrome; lt.: left; MRI: magnetic resonance imaging; PFA: paroxysmal fast activity; rt.: right; SPECT: single-photon emission computed tomography; SPS: simple partial seizure; SSW: slow spike-and-wave; sz.: seizure.