ArticleActa neurochirurgica2024
Awake surgery with mapping-based resection to treat focal epilepsy in eloquent brain areas.
Article in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Awake resection of temporal encephalocele associated with drug-resistant epilepsy: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- A pilot comparative study of intraoperative results and surgical outcomes between asleep-awake-asleep and general anesthesia modalities in temporal lobe resections.Neurosurgical review · 2026Article
- Multimodal Imaging in Epilepsy Surgery for Personalized Neurosurgical Planning.Journal of personalized medicine · 2025Review
- Feasibility and safety of awake craniotomy in adult patients with drug-resistant focal epilepsy.Epilepsia · 2025Observational
- Precision Neuro-Oncology in Glioblastoma: AI-Guided CRISPR Editing and Real-Time Multi-Omics for Genomic Brain Surgery.International journal of molecular sciences · 2025Review
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Authors and funding
9 authors.
Funding
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Abstract
objectivesResective surgery is a potential therapeutic option for select patients with intractable focal epilepsy. However, the presence of ictal onset zones within or surrounding highly functional brain areas presents a surgical challenge, leading to poor seizure and functional outcomes. This report describes our experiences with awake mapping-tailored resection of epileptogenic areas involving eloquent cortices and evaluates their feasibility, tolerance, limitations, and significance.
methodsThe study included patients who underwent surgery for drug-resistant focal epilepsy at our center under awake conditions. The surgical approach aimed to achieve maximum resection of preoperatively defined epileptogenic zones, considering the boundaries defined by surrounding functional areas. We collected data on preoperative evaluations, intraoperative tests and seizures, postoperative status epilepticus, and neurological functional outcomes.
resultsWe included 22 patients, 10 of whom had non-lesional epilepsy. Language, motor function, and sensory function were at risk in 19, 9, and 4 patients, respectively. Resection was performed as planned in 14 (63.6%) patients, while modifications were necessary in 8 (36.4%) patients due to functional constraints. The mean follow-up duration was 29.8 months. Sixteen (72.7%) patients achieved Engel class Ia outcomes, indicating seizure freedom, while none of the patients experienced clinically significant permanent postoperative neurological deficits. SIGNIFICANCE: Resective surgery with intraoperative brain mapping under awake conditions was a valid treatment option for achieving a cure in cases of drug-resistant focal epilepsy, even in situations in which the condition is considered inoperable due to the risk of significant postoperative neurological deficits.
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