Prevalence of "surgical" epilepsy cases - Study of a group of patients with drug-resistant focal epilepsy

Follow-lip of a cohort of patients with drug-resistant focal epilepsy. This study reports a cohort of 500 consecutive patients with confirmed epilepsy , who were first referred to our centre in 1987-1988. A prospective classif ication of the epilepsy type was performed and corrected annually. Patients with drug-resistant focal epilepsy (n = 91) were classified into 3 groups, according to the existence of a contra-indication to surgical treatment of epilepsy (n = 65), or of clear (n = 10) or doubtful indication (n = 16). T hus only ten patients were clearly candidates for surgery (2% of the total sample, or 11% of the drug resistant focal epilepsy group) while 16 others had less clear indications. The medical records were checked in 1991, 1993 and 1997 in order to evaluate the final outcome. Only 5 patients were opera ted including 2 who had been considered non-surgical at the onset. The fact ors lending to contra-indication of epilepsy surgery are many, they may be linked to the epilepsy or to the patient's individual situation.