Results of surgery for extratemporal partial epilepsy that began in childhood
J. Adler, G. Erba, K. R. Winston, K. Welch and C. T. Lombroso
Department of Surgery, (Neurosurgery), Stanford University Medical School, Calif.
Thirty-five consecutive patients who underwent surgery for intractable
extratemporal seizures originating in childhood are described. Candidates
for surgery were selected on the basis of clinical criteria,
neurodiagnostic imaging, and an electroencephalographic investigation that
included the use of sphenoidal electrodes and long-term monitoring.
Invasive preoperative monitoring was not used. Our results, with respect to
the control of seizures and behavioral improvement, are comparable with
series in which data from invasive recordings were used in the selection
process. Sixty-three percent of the 35 patients (76.5% of those operated on
after the introduction of long-term electroencephalographic monitoring)
became either seizure free or experienced a reduction in their frequency of
seizures by at least 75%. The favorable outcome in this group of patients
strengthens the argument for early operation in children with intractable
epilepsy, even when the seizure focus is outside the temporal lobe.
