Surgical treatment of epilepsy - clinical, radiological and histopathological findings in 139 children and adults

The present study relates clinical and radiological data to histopathologic al diagnoses in the first 139 patients (children and adults) in the Gotebor g Epilepsy Surgery series. Temporal lobe resections were most common (54.0% ) followed by frontal lobe (18.0%) and multilobar resections (11.5%). All h istopathological specimens were re-evaluated in connection with this study. Parenchymal malformations and atrophic-gliotic lesions were the most commo n histopathological findings. Microdysgenesis was more common than major ma lformations (24.5% versus 11.5%). When the MRI scans were blindly re-evalua ted the MRI findings correlated with histopathological diagnosis in all of the vascular malformations, in 77.8% of the tumours, in 76.5% of the cases with hippocampal sclerosis but only in 28.6% of the major cortical developm ent malformations. Hemispherectomies carried the best seizure outcome prognosis followed by te mporal lobe resections (75.0% versus 57.3% seizure free 2 years after surge ry). Vascular malformations carried the best, and microdysgenesis the worst prognosis (76.9% versus 39.4% seizure free).