INTRACTABLE EPILEPSY DUE TO MENINGITIS - RESULTS OF SURGERY AND PATHOLOGICAL FINDINGS

Between 1986 and 1992, among a total of 668 craniotomies performed for intractable epilepsy, 13 (1.9%) patients had a presumed aetiology of a previous episode of meningitis. Twelve were investigated with chroni c electrocorticography with subdural electrodes which showed mesial te mporal onset in eight, regional temporal onset in three and bilateral diffuse onset in one. One patient underwent corpus callosotomy and 12 anterior temporal lobectomy (ATL) (6L, 6R). The pathology in the resec tion cases was hippocampal sclerosis in six and gliosis in six. Mean l ength of follow up was 3 years (range 1-6 years). Ten of the 12 (83%) ATL patients were seizure free (six off medications). Two ATL patients and the callosotomy patient were significantly improved. It is conclu ded that in patients where the presumed aetiology of intractable epile psy is meningitis and widespread damage may therefore be expected, thi s does not necessarily indicate multifocality, and the prognosis follo wing resective surgery appears to be good.