Surgical treatment of epilepsy.
Seventy patients with intractable epilepsy were surgically treated. Thirty-three patients underwent a stereotactic procedure and in all as a first-stage operation fornicotomy was performed. Because of inadequate results in 14 patients, an additional stereotactic intervention was necessary; the targets were amygdala, thalamus, and Forel's H-field, and the final outcome of these patients was 9 (27%) seizure-free, 19 (58%) improved, and 5 (15%) unchanged. In 3 patients a selective amygdalo-hippocampectomy was performed with 2 seizure-free patients and one with improvement. Topectomy in focal epilepsy in 5 patients resulted in freedom from seizures in all cases. In 23 patients a lobectomy was performed; 10 (43%) were seizures-free, 8 (35%) were improved, and 5 (22%) were unchanged. In 6 patients only a pathological lesion was resected. Our results speak in favour of ablative surgery. However, stereotactic operations are indicated in cases with secondary generalization and dissipated foci on the dominant hemisphere.
Pendl
G
G
Department of Neurosurgery, University of Graz, Austria.
Grunert
P
P
Graf
M
M
Czech
T
T
D000328:Adult; D000679:Amygdala / Q000601:surgery; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011612:Psychosurgery; D013238:Stereotaxic Techniques; D013788:Thalamus / Q000601:surgery