A 13-year experience with epilepsy surgery

Between 1985 and 1997, 563 therapeutic craniotomies were performed: 311 anterior temporal (ATL) and 158 extramesial temporal (XMT) resections, 67 callosotomies, 20 hemispherectomies and 7 multiple subpial transections. Sixty-seven percent of nonlesional ATL cases were seizure free (SF), and 76% of nonlesional ATL cases less than or equal to 18 years old were SF. Seventy eight percent of lesional ATL cases with complete resection were SF. Seventy-th ree percent of lesional cases less than or equal to 18 were SF. Thirty-seven percent of nonlesional XMT cases were SF. Seventy percent of XMT lesional cases with complete resection were SF, and 82% of lesional XMT cases less than or equal to 18 were SF. Of the anterior callosotomy cases, there was a greater than or equal to 90% decrease in generalized tonic-clonic seizures in 50% of patients, and in tonic seizures, drop attacks, absence and myoclonic seizures in approximately 60-70% of patients. Of 20 hemispherectomies, 65% were SF. Of 7 multiple subpial transections, 29% were SF. Copyright (C) 2000 S. Karger AG, Basel.