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Subcentimeter epilepsy surgery targets by resting state functional magnetic resonance imaging can improve outcomes in hypothalamic hamartoma.

Varina L BoerwinkleStephen T FoldesSalvatore J TorrisiHamy TemkitWilliam D GaillardJohn F KerriganVirendra R DesaiJeffrey S RaskinAditya VedantamRanda JarrarKorwyn WilliamsSandi LamManish RanjanJanna S BrodersonDavid AdelsonAngus A WilfongDaniel J Curry
Published in: Epilepsia (2018)
For the first time, surgical SLA targeting of subcentimeter-sized EZs, located by rs-fMRI, guided surgery for intractable epilepsy. Our outcomes demonstrated the highest seizure freedom rate without surgical complications and are a significant improvement over prior reports. The approach improved freedom from seizures by 45% compared to conventional ablation, regardless of hamartoma size or anatomical classification. This technique showed the same or reduced morbidity (0%) compared to recent non-rs-fMRI-guided SLA studies with as high as 20% permanent significant morbidity.
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