EXTRATEMPORAL CORTICAL RESECTIONS AND LESIONECTOMIES FOR PARTIAL EPILEPSY - COMPLICATIONS OF SURGICAL-TREATMENT

Fifty patients with medically refractory extratemporal seizures underw ent epilepsy surgery at our institution between 1988 and 1992. Twenty- nine patients (group I) had an extratemporal (mainly frontal lobe) cor ticectomy, and 21 patients (group II) had an epileptogenic lesion exti rpated without resection of the epileptic brain tissue. Comprehensive neurologic evaluation was performed preoperatively, soon after operati on, and similar to 3 months postoperatively to assess operative outcom e. Magnetic resonance imaging (MRI) in group I patients usually showed no abnormality or a large destructive lesion. Neuroimaging showed a f oreign tissue lesion in most group II patients. Thirteen of the 29 pat ients who underwent corticectomy had at least one adverse event (AE) p otentially related to operation at the time of initial assessment. Fou r of the 13 patients required a surgical procedure to treat the operat ive complication, but only 1 of the 13 patients had a persistent neuro logic deficit at follow-up examination. Three of the 21 patients who r eceived lesionectomy had acute and persistent neurologic morbidity. Pa tients undergoing cortical resection remained intubated longer postope ratively (p < 0.005), and required longer hospitalization after operat ion (p < 0.001) and in the intensive care unit (p < 0.001) as compared with the lesionectomy group. Results of this study may prove useful i n counseling patients regarding neurologic outcome after extratemporal surgery.