Surgical treatment of epilepsy: three- to six-year follow-up of eleven patients with pharmacologically uncontrolled complex partial seizures.
There are an estimated 100,000 epileptic patients whose response to pharmacologic treatment is unsatisfactory. We report 11 patients with complex partial seizures who were selected for surgical treatment after adequate trials on antiepileptic medication failed. Immediate improvement-no further seizures or reduced frequency of occurrence and severity-was sustained at 3- to 6-year follow-up, and 7 patients were driving, 10 were working, and all were enjoying a better quality of life. Likely candidates for temporal lobectomy or resection of epileptogenic cerebral cortical lesions are those with a single focus of seizure discharge on video-EEG monitoring. If this focus is remote from language or motor areas, and if there is no interference with memory and recall after intracarotid amobarbital injection ipsilateral to the intended surgery, good results can be expected in the majority of such patients. We discuss patient selection and evaluation, and encourage surgical treatment where the indications can be established.
Ferriss
G S
GS
Dept of Medicine, Southern Baptist Hospital, New Orleans, LA.
Green
J B
JB
Miller
C F
CF
D000293:Adolescent; D000328:Adult; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011612:Psychosurgery / Q000379:methods*; D013702:Temporal Lobe / Q000601:surgery