Results of lesional vs. nonlesional frontal lobe epilepsy surgery.
Fifty-three seizure focus resections limited to the frontal lobe were performed. Forty-nine had adequate follow-up. Five of 17 (29%) nonlesional (NL) cases and 21 of 32 (66%) lesional (L) cases were seizure free (SF) at 1 year postoperatively. Eight of 9 (89%) L cases < or = 18 years old vs. 13 of 23 (57%) > 18 years old were SF. Eight of 10 (80%) tumor vs. 13 of 22 (59%) nontumor L cases were SF. Sixteen NL cases were localized by invasive recording. Five (31%) were SF. Ictal localization was obtained in 4 of 32 L cases. Three of 4 (75%) were SF. Eighteen of 24 (64%) L cases without ictal localization were SF. Nine of 12 (75%) lateral resections, 7 of 12 (58%) lobectomies, and 2 of 13 (15%) mesial resections were SF. Three of 20 cases with at least 90% reduction in seizures became SD > or = 2 years postresection. No case with < 90% seizure reduction at one year showed improvement with longer follow-up.
Smith
J R
JR
Section of Neurosurgery, Medical College of Georgia, Augusta, USA. deptsurg.jsmith@mail.mcg.edu
Lee
M R
MR
King
D W
DW
Murro
A M
AM
Park
Y D
YD
Lee
G P
GP
Loring
D W
DW
Meador
K J
KJ
Harp
R
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001927:Brain Diseases / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D002648:Child; D004567:Electrodes, Implanted; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome