Surgical management of epilepsy associated with developmental anomalies of the brain

BACKGROUND Disorders as the central nervous system forms during the pre-, peri-, or postnatal periods may cause developmental anomalies of the brain. Such maldevelopment, ranging from slight to severe disturbances, appears to be the mechanism for causing childhood seizure disorders. However, the sur...

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Bibliographic Details
Published in:Surgical neurology 1995-02, Vol.43 (2), p.182-190
Main Authors: Liu, Ming-ying, Yeh, Hwa-shain, Blisard, Karen, Gartner, Maureen
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brain - abnormalities
Child
Child, Preschool
Cortisectomy
developmental anomalies
Electroencephalography
Epilepsies, Partial - etiology
Epilepsies, Partial - pathology
Epilepsies, Partial - physiopathology
Epilepsies, Partial - surgery
epilepsy
Female
Follow-Up Studies
Humans
Male
surgical treatment
Treatment Outcome
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Summary:BACKGROUND Disorders as the central nervous system forms during the pre-, peri-, or postnatal periods may cause developmental anomalies of the brain. Such maldevelopment, ranging from slight to severe disturbances, appears to be the mechanism for causing childhood seizure disorders. However, the surgical treatment of these lesions responsible for intractable partial seizures remains undefined. METHOD Twenty-two patients (8 males, 14 females) with chronic seizure disorders associated with structural lesions of the brain related to developmental anomalies were surgically treated (1983 to 1990). Imaging studies, intraoperative findings, and histology showed 12 lesions in the temperal lobe, 1 in the frontal lobe, and 9 of multilobular involvement. All patients had preoperative prolonged electroencephalography with sphenoidal electrodes. Sixteen patients had ultraoperative electrocoticography. All underwent crathiotomy and total excision of the epileptogenic zone the speech or motor cortex was involved. RESULTS Results of postoperative seizure control during the follow up period (mean 35 years) were excellent) seizure free) in 12 patients (including four with complete and eight with incomplete excision of the structural lesion), good in seven, fair in two, and poor in one. CONCLUSION Seizure control is possible for patients with total excision of the epileptogenic, one event including those with incomplete excision of a structural lesion caused by developmental brain anomalies.
ISSN:0090-3019
1879-3339
DOI:10.1016/0090-3019(95)80132-Z