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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Surgical treatment of extratemporal epilepsies: experience with 253 procedures

Meeting Abstract

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  • C. Scheiwe - Neurochirurgische Universitätsklinik Freiburg, Abteilung Allgemeine Neurochirurgie, Freiburg
  • S. Fauser - Neurochirurgische Universitätsklinik Freiburg, Abteilung Allgemeine Neurochirurgie, Freiburg
  • J. Zentner - Neurochirurgische Universitätsklinik Freiburg, Abteilung Allgemeine Neurochirurgie, Freiburg

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.13.05

doi: 10.3205/11dgnc101, urn:nbn:de:0183-11dgnc1019

Published: April 28, 2011

© 2011 Scheiwe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Extratemporal epilepsies remain a challenge both with respect to presurgical evaluation and surgical treatment since the epileptogenic area is frequently diffuse and overlaps eloquent areas. Therefore, extratemporal epilepsies usually require extensive presurgical work-up including invasive recordings. Here, we provide an overview on our experience with a total of 253 procedures in 236 patients.

Methods: Between 1998 and 2010 a total of 236 patients received 253 therapeutic procedures. Histopathological specimen were available in 226 patients. Epileptological follow-up of at least 1 year (range from 3 to 120 months) was obtained in 158 patients. In 75 patients (32%), invasive mapping with subdural and/or depth electrodes was performed prior to surgery.

Results: The majority of resections concerned the frontal lobe (55.9%; parietal: 6.2%, occipital: 8.2%). Multilobectomy involving 2 lobes was performed in 16.4% and involving 3 lobes in 5.6% of the cases. Histopathological examination revealed focal cortical dysplasia in 48.9%, other non-neoplastic lesions in 26.9% and neoplastic lesions in 24.2% of the specimen. During a mean follow-up of 36 months, 97 (61.4%) of the patients remained seizure-free, 38 (24%) had a significant seizure reduction of > 75%. Operative complications were temporary in 38 cases (20%) and permanent in 4 cases (2.1%). There was no operative mortality.

Conclusions: Extratemporal resections provide satisfying epileptological results. This is also true for complex procedures.