Epilepsy surgery: removing the thorn from the lion's paw.
In the United States, 10,000 to 20,000 patients have epilepsy uncontrolled by medication. The addition of a second-line drug to the primary regimen has a 2% to 11% chance of controlling the seizures. We present a series of 35 patients with intractable epilepsy who had surgical resection of their seizure focus. Seventy-five percent of the patients with temporal lobe epilepsy were made seizure free, with an additional 14% sustaining a greater than 90% reduction in seizures (decrease in number and frequency). Seventy-one percent of the patients with extratemporal lobe epilepsy (seizures originating outside the temporal lobe) had a worthwhile reduction (> 90%) in their seizures. Two patients sustained permanent clinically significant deficits as a result of their presurgical evaluation or resection. There were no deaths. Epilepsy surgery offers a cure for the "incurable" patient with a morbidity of 5% to 6%.
Holloway
K L
KL
Department of Neurosurgery, Medical College of Virginia, Richmond 23298, USA.
Corrie
W S
WS
Wingkun
E C
EC
Johnson
M H
MH
Kuta
A J
AJ
D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000150:complications / Q000473:pathology; D002648:Child; D003337:Corpus Callosum / Q000601:surgery; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011183:Postoperative Complications; D013355:Subdural Space; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery; D014743:Videotape Recording