Postsurgical outcome of children and adolescents with medically refractoryfrontal lobe epilepsies

Objects: In the adult population surgical treatment is generally less favor able for refractory frontal lobe epilepsy (FLE) than for temporal lobe epil epsy (TLE). Predictive factors and outcome of FLE surgery had not previousl y been described for the pediatric and adolescent population. Therefore, 32 children and adolescents who underwent FLE surgery were analyzed in this s tudy. Methods: Medical records were reviewed for demographic data, presurgi cal evaluation procedures, surgical procedures, pathological findings and f ollow-up. Results: Mean age at operation was 10.8 years, with seizure onset at 4.6 years. Excellent outcomes were observed in 21 of the 32 patients fo llowing evaluation a mean of 34.5 months after surgery. Nineteen of 22 pati ents became seizure free after tailored resections, versus 2 out of 10 afte r lobectomy. Transient neurological and surgical complications occurred in 4 patients. Focal neoplastic lesions detectable by MRI were associated with a favorable outcome. Conclusions: As seen in adult FLE series, the detecti on of a resectable ictal neoplastic lesion on preoperative MRI is associate d with an excellent outcome comparable to that of TLE surgery.