SURGICAL-TREATMENT FOR PARTIAL EPILEPSY AMONG NORWEGIAN ADULTS

We conducted a retrospective longitudinal self-controlled study of 124 adult patients treated with resective surgery for medically uncontrol led partial epilepsy from 1949 to 1988. Approximately 65% of the patie nts experienced >95% reduction in seizure frequency, and 75% had worth while improvement of at least 75% seizure reduction. Significant reduc tions were noted in all major seizure types treatable with resective s urgery; complex partial (CPS), simple partial (SPS), and secondarily g eneralized tonic-clonic seizures (GTC) (all p < 0.05). Tissue patholog y and region of resection did not provide significant information with respect to seizure outcome. EEG in the first postoperative year was a n important predictor of long-term seizure outcome (p 0.03). One third of the temporal lobe resected patients had neurologic deficits as a c onsequence of the resection as compared with 14% of patients with fron tal resections (p = 0.03). One third of the deficits among the tempora l lobe resected patients were considerable, with possible social impli cations. Half of the patients with preoperative focal spike activity h ad a normal EEG postoperatively. One fifth of patients maintained thei r preoperative epileptic focus after the operation, and about one fift h displayed new foci. Approximately one fourth of the patients were fr ee of medication for a median of 16 years postoperatively, and 60% of patients who were seizure-free were still receiving medication. There was no operative mortality, but the late mortality, as expected, was h igher than that of the general population. Two male patients (1.6%) co mmitted suicide.