Postsurgical outcome of children and adolescents with medically refractory frontal lobe epilepsies.
OBJECTIVE
In the adult population surgical treatment is generally less favorable for refractory frontal lobe epilepsy (FLE) than for temporal lobe epilepsy (TLE). Predictive factors and outcome of FLE surgery had not previously been described for the pediatric and adolescent population. Therefore, 32 children and adolescents who underwent FLE surgery were analyzed in this study.


METHODS
Medical records were reviewed for demographic data, presurgical evaluation procedures, surgical procedures, pathological findings and follow-up.


RESULTS
Mean age at operation was 10.8 years, with seizure onset at 4.6 years. Excellent outcomes were observed in 21 of the 32 patients following evaluation a mean of 34.5 months after surgery. Nineteen of 22 patients became seizure free after tailored resections, versus 2 out of 10 after lobectomy. Transient neurological and surgical complications occurred in 4 patients. Focal neoplastic lesions detectable by MRI were associated with a favorable outcome.


CONCLUSIONS
As seen in adult FLE series, the detection of a resectable ictal neoplastic lesion on preoperative MRI is associated with an excellent outcome comparable to that of TLE surgery.
Kral
T
T
Department of Neurosurgery, University of Bonn, Medical Center, Sigmund Freud Strasse 25, 53105 Bonn, Germany. Thomas.Kral@ukb.uni-bonn.de
Kuczaty
S
S
Blümcke
I
I
Urbach
H
H
Clusmann
H
H
Wiestler
O D
OD
Elger
C
C
Schramm
J
J
D000293:Adolescent; D001927:Brain Diseases / Q000150:complications / Q000601:surgery*; D001932:Brain Neoplasms / Q000601:surgery; D002648:Child; D017034:Epilepsy, Frontal Lobe / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome