title: Surgical treatment for patients with symptomatic generalised seizures due to brain lesions.
abstract: OBJECTIVE
  To study the role of epilepsy surgery for patients with focal lesions who exhibited the semiology of clinically generalised seizures.
  
  
  METHODS
  From our epilepsy surgery series, we identified 29 patients who underwent surgery for seizures, including certain types of generalised seizures, according to their ictal semiology. We systematically reviewed the brain imaging, video-EEG, surgical operation, and pathological findings data of these patients.
  
  
  RESULTS
  All patients had at least one type of generalised seizure according to the semiology; these seizures included epileptic spasms, myoclonic seizures, tonic seizures, atonic seizures and atypical absence seizures. Eight patients had a single type of seizure, 11 patients had two types of seizures, and 10 patients had more than two types of seizures. In addition to symptomatic generalised seizures, complex partial seizures were also recorded in eight patients. In 24 patients, the ictal semiology showed slight asymmetric movements in certain types of seizures. Generalised interictal epileptic discharges were recorded in 24 patients; and generalised ictal epileptic discharges as the only EEG pattern were recorded in 13 patients. Intracranial recording was performed in 20 patients; 10 of whom showed a rhythm of fast activities at the initiation of the seizures. Functional hemispherectomy was performed for three patients with hemispheric lesions. Focal resection of the epileptogenic zone was performed in 26 patients. The resected epileptogenic zones involved a single lobe in 10 patients, two lobes in 11 patients, and three lobes in 5 patients; the parietal lobe was the most commonly involved lobe (in 19 cases). Scar lesions (in 17 patients) were most commonly observed on pathological examination. At the last follow-up (mean 18±8.3 months, range 12-48), 17 (58.6%) patients were seizure-free.
  
  
  CONCLUSIONS
  Certain patients with local brain lesions can have seizures with specific types of generalised semiology. An appropriate operation may be helpful for a portion of these patients.
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China. Electronic address: yutaoly@sina.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Guojun
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Comprehensive Epilepsy Center of Beijing, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Duanyu
authors.initials: D
authors.lastname: Ni
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Qiao
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Du
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Piao
authors.affiliation: Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D038421:Hemispherectomy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014743:Videotape Recording
keywords: Epileptogenic zone; Generalised seizure; Lesion; Semiology; Surgery