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John Adler, MD; Giuseppe Erba, MD; Ken R. Winston, MD; Keasley Welch, MD; Cesare T. Lombroso, MD, PhD

Arch Neurol. 1991;48(2):133-140.

Abstract
• 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.

Author Affiliations
From the Department of Surgery (Neurosurgery), Stanford (Calif) University Medical School (Dr Adler); Department of Neurology, University of Rochester (NY) (Dr Erba); Department of Surgery (Neurosurgery), University of Colorado Health Sciences Center, Denver (Dr Winston); and Departments of Neurosurgery and Neurology (Seizure Unit), The Children's Hospital and Harvard Medical School, Boston, Mass (Drs Welch and Lombroso).

Footnotes
Accepted for publication June 29, 1990.

Reprint requests to Box B467, The Children's Health Center, 1950 Ogden St, Denver, CO 80218 (Dr Winston).

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