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Dipole localization in surgical treatment of epileptic foci secondary to intracranial mass lesions: retrospective analysis of 47 cases.

OBJECTIVE
To assess the value of dipole localization in the surgical treatment of epileptic foci arising from intracranial mass lesions and observe the long-term effect of this technique.


METHOD
With the assistance if dipole localization system for epileptic foci and magnetic resonance imaging (MRI), we performed precise localization of the epileptic foci secondary to the intracranial mass lesions both preoperatively and during the surgeries in 47 cases. The clinical features of this type of epilepsy and the precautions essential for the operations were reviewed, with the long-term outcome of the patients analyzed on the basis of a follow-up study for at least 1 year of all these cases.


RESULTS
The mean follow-up duration was 27.9 months. After the operations, 35 patients (74.5%) were completely seizure-free or with only postoperative auras, and 7 (14.9%) had only rare fits of seizures (fewer than 3 in a year), accounting for a rate for satisfactory seizure control of 89.4% and a rate for obvious improvement of 6.4% (n=3, with at least an 75% seizure reduction). Only 2 patients (4.3%) failed to respond favorably to the surgery by showing less than 75% seizure reduction. No severe long-term complications were found in these cases.


CONCLUSION
Dipole localization is capable of accurate localization of the secondary epileptic foci to provide precise guidance for their surgical treatment, with which improvement of the therapeutic effect and reduction of the complications can be achieved.