Abstract
The basis of the differential diagnosis of uncontrollable epilepsies are above all non-invasive imaging methods and long-term video-EEG monitoring. In patients included in an epileptosurgical programme also semi-invasive and invasive methods play a role to a different extent.
The objective of the examination is to obtain a maximum of valid information while reducing the burdening of the patient and financial costs to a minimum. Therefore a suitable combination of different methods and ways of evaluation of their effectiveness are sought.
One of the criteria of usefulness of an applied method in operated patients can be a correlation with the postoperative frequency of attacks. In the submitted trial the authors evaluated the yield of video-KEG monitoring in 94 patients who were examined on account of uncontrollable epilepsy at the Unit for intensive monitoring at the Faculty Hospital Motel in 1995-1997.
In all patients magnetic resonance (MRI) was applied; among preoperative methods also proton magnetic resonance spectroscopy (1RMRS) was included. In operated patients the authors compared preoperative findings and applied methods with postoperative results.
A favourable postoperative course confirmed the correct indication in 65% of patients, the best results were obtained in patients with temporal epilepsy (76% successfully operated). In patients operated only on the basis of non-invasive methods the postoperative development was favourable in 81%, in invasively monitored patients surgery was successful in half of the patients.