PARIETAL LOBE LESIONAL EPILEPSY - ELECTROCLINICAL CORRELATION AND OPERATIVE OUTCOME

We retrospectively studied ictal behavior, extracranial EEG, and opera tive outcome in 10 consecutive patients with intractable partial epile psy of presumed parietal lobe origin who received a lesionectomy, i.e. , resection of the neuroimaging-identified abnormality, at the Mayo Cl inic. Nine patients had a pathologically verified foreign-tissue lesio n, e.g., tumor or vascular malformation, and 1 patient had gliosis. Al l patients with foreign-tissue lesions were rendered seizure-free. The patient with gliosis experienced a reduction in seizure tendency. The re were no operative complications. The most common seizure type was a simple partial seizure with visual, motor, or sensory symptoms (n = 8 ). Complex partial seizures (n = 5) and secondarily generalized tonic- clonic seizures (GTC, n = 2) were also observed. The ictal behavior wa s often nonspecific although useful in identifying lateralization of t he epileptogenic zone. Extracranial interictal and ictal EEG changes w ere unreliable markers of the parietal lobe origin of seizure activity . Lesionectomy without chronic intracranial monitoring or functional m apping may be an effective and safe alternative surgical procedure in patients with partial epilepsy related to parietal lobe lesions.