+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Multilobar resections in surgical treatment of medically intractable epilepsy

Multilobar resections in surgical treatment of medically intractable epilepsy

Neurologia i Neurochirurgia Polska 32(Suppl. 2): 81-94

MATERIAL, METHOD: Authors present the results of surgical treatment in a series of 93 patients with medically intractable epilepsy and large epileptogenic foci, in whom multilobar resections have been performed. They constituted 13% of a group of 716 patients subjected to surgery due to drug resistant epilepsy in the period 1957-1996, in the Department of Neurosurgery, Medical University of Warsaw, Poland. Patients treated with multilobar resection constituted the group, characterised by the most severe course of epilepsy, so they usually had a long seizures' history at the time of operation (more than 10 years duration of the disease in 37% of patients), albeit they were qualified to surgery at a relatively young age (mean age at the time of surgery: 16-th year of life). Trauma was the most frequent underlying aetiologic factor (perinatal trauma and other major head injury were documented in 28% and 30% of patients respectively). Morphological abnormalities of the resected brain tissue were found on pathological examination (light microscope) in 68% of patients in this series. Perioperative mortality was 3%. At a follow-up examination (mean follow-up period 7 years postoperatively): 30% of patients were seizure free, in 13% of patients drug discontinuation was possible. In 23% of patients less than 2-3 seizures per year occurred. So totally in 53% of patients, good result of treatment was achieved (none or only very rare seizures). In 35% of patients surgery failed to control seizures' frequency. 9% of patients were lost from follow-up evaluation. Multilobar resection (if acceptable from the clinical point of view) may be an effective treatment choice in patients with medically uncontrollable seizures and huge epileptogenic foci. This treatment modality may offer recovery from seizures or significant improvement to 53% of patients treated. The radical removal of epileptogenic foci, age of the patients higher than 18 year of life at the time of operation, focal character of EEG abnormalities and occurrence of only one type of seizures, were found to be good prognostic factors. On the other hand younger age of the patients operated, the presence of generalized slow waves in the interictal EEG recordings and the occurrence of various types of seizures, influenced adversely on the prognosis.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 046739094

Download citation: RISBibTeXText

PMID: 9757434

Related references

Lobar and multilobar resections for medically intractable pediatric epilepsy. Pediatric Neurosurgery 34(6): 311-318, 2001

Lobar and Multilobar Resections for Medically Intractable Pediatric Epilepsy. Pediatric Neurosurgery 34(6): 311-318, 2001

Cortical resections outside the temporal lobe for intractable epilepsy--excluding multilobar resections and hemispherectomy. Acta Neurochirurgica. Supplementum 50: 128-130, 1990

Surgical treatment for intractable paediatric epilepsy with widespread or multilobar cortical dysplasia. 2007

The use of high frequency oscillations to guide neocortical resections in children with medically-intractable epilepsy: how do we ethically apply surgical innovations to patient care?. Seizure 21(10): 743-747, 2012

Surgical treatment of neoplasms associated with medically intractable epilepsy. Neurosurgery 41(2): 378-86; Discussion 386-7, 1997

Surgical treatment of children with medically intractable epilepsy--outcome of various surgical procedures. Neurologia Medico-Chirurgica 36(5): 305-309, 1996

Surgical Treatment of Children with Medically Intractable Epilepsy Outcome of Various Surgical Procedures-. Neurologia medico-chirurgica 36(5): 305-309, 1996

Surgical treatment of medically intractable epilepsy due to perinatal infarction. 2007

Prognostic factors in the surgical treatment of medically intractable epilepsy associated with mesial temporal sclerosis. Acta Neurologica Scandinavica 103(6): 344-350, 2001

Surgical treatment of children with medically intractable frontal or temporal lobe epilepsy: results and highlights of 40 years' experience. Epilepsia 34(2): 244-247, 1993

Surgical treatment of intractable seizures with multilobar or bihemispheric seizure foci (MLBHSF). Surgical Neurology 47(1): 72-78, 1997

Surgical therapy for medically intractable epilepsy. Journal of Neurosurgery 66(4): 489-499, 1987

Surgical decisions regarding medically intractable epilepsy. Clinical Neurosurgery 38: 548-566, 1992

Multilobar Resections for 3T MRI-Negative Epilepsy: Worth the Trouble?. World Neurosurgery 123: E338-E347, 2019