Long‐Term Follow‐Up of Stereotactic Lesionectomy in Partial Epilepsy: Predictive Factors and Electroencephalographic Results

Gregory D. Cascino, Patrick J. Kelly, Frank W. Sharbrough, Joseph F. Hulihan, Kathryn A. Hirschorn, Max R. Trenerry

Research output: Contribution to journalArticle

137 Scopus citations

Abstract

Summary: We performed an extended follow‐up study assessing the efficacy of stereotactic lesionectomy in 23 patients with foreign‐tissue lesions and intractable partial epilepsy. Sixteen lesions involved functional or eloquent cortex as determined by anatomic localization. By definition, the surgical objective in these patients was excision of the lesion, and not the surrounding cerebral cortex. The mean duration of follow‐up was 48.5 months (range 26–69 months). Seventeen patients (74%) had a significant reduction in seizures (90%) after lesionectomy. Thirteen patients (56%) had a class I operative out‐come (seizure‐free, single seizure episode, or auras only). Five of these patients were successfully discontinued from antiepileptic drug (AED) therapy. Patients with temporal lobe lesions were statistically less likely to be rendered seizure‐free (p < 0.05). Age at operation, duration of epilepsy, and underlying pathology were not significant predictors of seizure outcome. The anatomic distribution of extracranial EEG recorded epileptiform activity did not appear to be an important determinant of outcome. The absence of interictal epileptiform activity in the 3‐month postoperative EEG correlated with a significant reduction in seizures. Long‐term follow‐up indicates that lesionectomy may be effective in select patients with medically refractory partial seizure disorders.

Original languageEnglish (US)
Pages (from-to)639-644
Number of pages6
JournalEpilepsia
Volume33
Issue number4
DOIs
StatePublished - Jul 1992

Keywords

  • Neurosurgery
  • Partial epilepsy
  • Pathology
  • Stereotactic lesionectomy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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