Table 1 The detailed clinical information of patients
No | Gender | Age at surgery (y) | Age at seizure onset (y) | Seizure types | Focal semiology | Seizure frequency | Etiology | IQ | Preoperative anti-seizure medications | Scalp EEG | SEEG | MRI | PET | Surgery | Postoperative EEG | outcome (ILAE class) | Histopathologic findings |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Male | 5 | 3 | LGS: spasms/tonic/ focal /atypical absence | Right upper limb tonic | every day | Structural (Malacia) | 42 | OXC, VPA, LEV, TPM | Interictal: asymmetry SWD, paroxysmal fast activities, generalized discharge; Ictal: focal (right hemisphere) & generalized | - | Encephalomalacia of the left hemisphere | Hypometabolism of the left hemisphere | Left hemispherectomy | ED disappeared | 1 | Nonspecific gliosis |
2 | Female | 13 | 3 | LGS: spasms/tonic/ focal /atypical absence/focal to bilateral tonic-clonic seizures | Left upper limb tonic and, turning of head and eyes to the left | per week | Structural (Ischemic encephalatrophy) | 56 | LTG, LEV, OXC | Interictal: asymmetry SWD, paroxysmal fast activities, posterior discharge; Ictal: focal (right hemisphere) & generalized | - | Right parietal-occipital encephalomalacia | Hypometabolism at right temporal lobe, parietal lobe, occipital lobe | Right occipital and posterior temporal resection | ED remarkably improved | 1 | Nonspecific gliosis |
3 | Male | 6 | 0.2 | LGS: focal spasms/tonic/atypical absence | Head nodding to the left | every day | Structural (Malacia after intracerebral hemorrhage) | 25 | VPA, CZP, TPM | Interictal: asymmetry SWD, paroxysmal fast activities, anterior cortex discharge; Ictal: focal (right frontal) & generalized | - | Encephalomalacia of the right hemisphere | - | Right hemispherectomy | ED disappeared | 1 | Nonspecific gliosis |
4 | Male | 3 | 0.2 | LGS: spasms/tonic/atypical absence/focal to bilateral tonic-clonic seizures | Turning of head and eyes to the left | every day | Structural (Malacia) | - | OXC, VPA, LTG | Interictal: asymmetry SWD, paroxysmal fast activities, generalized discharge; Ictal: focal (left hemisphere) & generalized | - | Encephalomalacia of the right hemisphere | - | Right subtotal hemispherectomy | ED remarkably improved | 1 | Nonspecific gliosis |
5 | Male | 12 | 6 | LGS: spasms/tonic/atypical absence | - | every day | Structural (FCD) | 42 | VPA, CZP, TPM | Interictal: GSWD, paroxysmal fast activities, right frontal focal discharge; Ictal: focal (right frontal) & generalized | Tonic and spasm seizures: originate from medial right frontal lobe | Right frontal FCD | Right frontal hypometabolism | Right frontal partial resection | ED disappeared | 1 | FCDIIA |
6 | Male | 7 | 4 | LGS: spasms/ focal tonic/atypical absence | Left upper limb tonic | every day | Structural (Ischemic malacia) | 37 | OXC, VPA, LEV | Interictal: asymmetry SWD, paroxysmal fast activities, right parietal focal discharge; Ictal: focal ( right parietal) & generalized | - | Encephalomalacia of the left occipital lobe | Hypometabolism at right temporal lobe, parietal lobe and occipital lobe | Right parietal-occipital resection | ED remarkably improved | 1 | Nonspecific gliosis |
7 | Male | 6 | 4 | LGS: tonic/atypical absence/focal | Turning of tonic head to the right | every day | genetic &structural (Tuberous sclerosis complex) | 71 | LEV, VPA, OXC | Interictal: GSWD, paroxysmal fast activities, anterior cortex discharge. Ictal: focal (left hemisphere) & generalized | - | Multiple cortical tubers and subependymal nodules | Multiple hypometabolism in bilateral hemisphere | Resection of left frontal tuber and the surrounding tissue | ED remarkably improved | 1 | FCDII |
8 | Female | 23 | 2 | LGS: spasms/tonic/GTCS/atypical absence | -Â | Per week | Structural (Ischemic encephalatrophy) | 52 | LTG, LEV, VPA | Interictal: asymmetry SWD, paroxysmal fast activities; Ictal: focal (left temporal-parietal) & generalized | - | Left temporal-parietal atrophy | Hypometabolism at left temporal lobe, parietal lobe | Left temporal-parietal resection | ED improved, but not remarkably | 1 | Nonspecific gliosis |
9 | Male | 15 | 4 | LGS: spasms/atypical absence | - | every day | Structural (FCDII) | 56 | VPA, CBZ, TPM | Interictal: GSWD, paroxysmal fast activities, generalized discharge; Ictal: focal (left frontal) & generalized | spasm seizure: originate from left lateral frontal cortex | Left frontal FCD | Left frontal hypometabolism | Left frontal resection | ED remarkably improved | 1 | FCDIIA |
10 | Female | 7 | 5 | Non-LGS: focal to bilateral tonic-clonic seizures/atypical absence; | Left upper limb tonic | every day | Structural (Malacia) | 25 | LCM, VPA, LTG | Interictal: right parietal-occipital discharge; Ictal: focal (right parietal-occipital) & generalized | Focal to bilateral seizure: originate from right medial occipital cortex | Right temporal-parietal-occipital encephalomalacia | Hypometabolism at right temporal lobe, parietal lobe, occipital lobe | Right temporal-parietal-occipital resection | ED remarkably improved | 1 | Nonspecific gliosis |
11 | Male | 5 | 2 | Non-LGS: focal to bilateral tonic-clonic seizures/atypical absence | Right upper limb tonic | every day | structural (FCD) | 68 | OXC, TPM, VPA | Interictal: focal left central-parietal discharge; Ictal: focal (left central-parietal) & generalized | - | Left parietal FCD | Hypometabolism at left temporal lobe, parietal lobe | Left parietal resection | ED disappeared | 1 | FCDIIB |
12 | Female | 10 | 8 | Non-LGS: focal /typical absence | Turning of head to the left | Per week | Structural (FCD) | 76 | LTG, LEV, VPA | Interictal: right posterior discharge; Ictal: focal (right posterior) & generalized | - | Right medial parietal FCD | Right medial parietal hypometabolism | Right medial parietal resection | ED disappeared | 1 | FCDIIA |
13 | Female | 14 | 10 | Non-LGS: GTCS, typical absence | - | every day | Structural (FCD) | 78 | TPM, VPA, CBZ | Interictal: generalized left medial parietal discharge; Ictal: generalized | GTCS: originate from left posterior cingulated cortex; absence seizures: originate from left posterior cingulated cortex, and rapidly engaging, GSWD | Left posterior cingulated FCD | Left parietal Hypometabolism | Left medial parietal (including posterior cingulated cortex)resection | ED disappeared | 1 | FCDIIA |
14 | Male | 6 | 3 | Non-LGS: typical absence | - | every day | Structural (Right thalamic malacia) | 46 | LTG, LEV, CZP | Interictal: generalized right medial parietal discharge; Ictal: generalized | absence seizures: originate from right posterior cingulated cortex, and rapidly engaging, GSWD | Right thalamic malacia | Right medial parietal hypometabolism | Right medial parietal ( including cingulated cortex ) resection | ED remarkably improved | 1 | nonspecific gliosis |
15 | Female | 7 | 3 | Non-LGS: myoclonic /spasms/tonic/atypical absence | - | Per week | genetic structural (FCD) | 38 | VPA, LTG, TPM, PB | Interictal: Left parietal, occipital and posterior temporal discharge; Ictal: focal (left temporal, parietal) & generalized | - | Left posterior FCD | Hypometabolism at left temporal lobe, parietal lobe, occipital lobe | Left temporal, parietal and occipital resection | ED disappeared | 1 | FCDIIA |
16 | Male | 7 | 5 | Non-LGS: typical absence | - | every day | Structural (FCD) | 82 | VPA, TPM | Interictal: bilateral central-parietal discharge; Ictal: generalized | - | Right insular lobe FCD and adjacent arachnoid cyst | Hypometabolism at right temporal lobe | resection of the right temporal lobe | ED remarkably improved | 1 | FCDIA |