Epilepsy surgery: removing the thorn from the lion's paw

South Med J. 1995 Jun;88(6):619-25. doi: 10.1097/00007611-199506000-00004.

Abstract

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%.

MeSH terms

  • Adolescent
  • Adult
  • Brain Diseases / complications
  • Brain Diseases / pathology
  • Child
  • Corpus Callosum / surgery
  • Electrodes, Implanted
  • Electroencephalography
  • Epilepsies, Partial / diagnosis
  • Epilepsies, Partial / etiology
  • Epilepsies, Partial / pathology
  • Epilepsies, Partial / surgery*
  • Epilepsy, Temporal Lobe / diagnosis
  • Epilepsy, Temporal Lobe / etiology
  • Epilepsy, Temporal Lobe / pathology
  • Epilepsy, Temporal Lobe / surgery*
  • Follow-Up Studies
  • Hematoma / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Monitoring, Physiologic / instrumentation
  • Postoperative Complications
  • Subdural Space
  • Temporal Lobe / physiopathology
  • Temporal Lobe / surgery
  • Videotape Recording