Keywords
posterior cortex epilepsy - ulegyria - perinatal distress - intracranial EEG - epilepsy
surgery
Introduction: Epilepsies originating from the occipital, parietal, and/or the posterior edge of
the temporal lobe are grouped together as posterior cortex epilepsy (PCE).
Aims/Objectives: Our objective was to assess the role of various presurgical evaluations in PCE and
its surgical management and outcome.
Materials/Method: A retrospective analysis of clinical data from 62 PCE patients referred for surgery
was performed. The diagnosis was established by standard presurgical evaluation modalities,
including semiology, MRI, PET, SPECT, image post-processing, interictal, and ictal
scalp video-EEG, as well as additional intracranial EEG monitoring in selected cases.
Results: Out of 62 patients with ulegyria, 49 were male and 13 were female. Age of presentation
was from 2 years to 46 years (mean: 21 years). The etiology for gliosis was related
to neonatal hypoglycemia, hypoxia, sepsis, and meningoencephalitis; patients were
operated on for parietal and occipital resections, PTO disconnections, and selective
posterior callosotomy; and 64.3% reached ILAE class 1, with a mean follow-up period
of 3.51 (1–12) years. Additionally, 65% of patients had a long-term improvement in
cognitive performance.
Conclusion: Ulegyria is considered to be a major cause of posterior cortex epilepsy. Long-term
postoperative seizure outcome is favorable. Bilateral lesions should not be excluded
from surgical indication.
