Surgical treatment of intractable seizures with multilobar or bihemispheric seizure foci (MLBHSF)

Arun Angelo Patil, Richard V. Andrews, Richard Torkelson

Research output: Contribution to journalArticle

17 Scopus citations

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 languageEnglish (US)
Pages (from-to)72-77
Number of pages6
JournalSurgical neurology
Volume47
Issue number1
DOIs
StatePublished - Jan 1997

Keywords

  • Epilepsy
  • amygdala hippocampotomy
  • subpial-transections
  • surgery
  • topectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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