Abstract
BACKGROUND: Patients with multilobar or bihemispheric seizure loci (MLBHSF) are generally not considered candidates for major resective surgery because of the high risk of complications. A combination of relatively less invasive surgical procedures were used to treat 19 patients with intractable seizures with MLBHSF. METHODS: Epileptogenic areas were identified via standard techniques. Locations of the seizure loci were in two lobes of a hemisphere in 11 patients, three lobes of a hemisphere in four patients, four lobes of a hemisphere in one patient, and both hemispheres in three patients. All 19 patients had multiple subpial transections; in addition, seven patients had small topectomies and nine patients had amygdala hippocampotomies. RESULTS: The longest follow-up is 54 months and the median for follow-up is 33 months. Nine patients (47%) are either free of seizures or have only rare seizures; eight patients (41%) have greater than 90% reduction in seizure frequency; one patient (6%) has complete cessation of myoclonic seizures and secondary generalization, and greater than 50% reduction in partial complex seizures; and one patient (6%) has greater than 50% reduction in seizure frequency. There were no permanent operative complications. CONCLUSION: Though the follow-up is relatively short and the number of patients is small, these results are encouraging, because the majority of patients in this group were poor surgical candidates.
Original language | English (US) |
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Pages (from-to) | 72-77 |
Number of pages | 6 |
Journal | Surgical neurology |
Volume | 47 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1997 |
Keywords
- Epilepsy
- amygdala hippocampotomy
- subpial-transections
- surgery
- topectomy
ASJC Scopus subject areas
- Surgery
- Clinical Neurology