Results of Lesional vs. Nonlesional Frontal Lobe Epilepsy SurgerySmith J.R.a · Lee M.R.a · King D.W.b · Murro A.M.b · Park Y.D.b · Lee G.P.a · Loring D.W.b · Meador K.J.b · Harp R.a
a Section of Neurosurgery, b Department of Neurology, Medical College of Georgia, Augusta, Ga., USA
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Fifty-three seizure focus resections limited to the frontal lobe were performed. Forty-nine had adequate follow-up. Five of 17 (29%) nonlesional (NL) cases and 21 of 32 (66%) lesional (L) cases were seizure free (SF) at 1 year postoperatively. Eight of 9 (89%) L cases ≤ 18 years old vs. 13 of 23 (57%) > 18 years old were SF. Eight of 10 (80%) tumor vs. 13 of 22 (59%) nontumor L cases were SF. Sixteen NL cases were localized by invasive recording. Five (31 %) were SF. Ictal localization was obtained in 4 of 32 L cases. Three of 4 (75 %) were SF. Eighteen of 28 (64%) L cases without ictal localization were SF. Nine of 12 (75%) lateral resections, 7 of 12 (58%) lobectomies, and 2 of 13 (15%) mesial resections were SF. Three of 20 cases with at least 90% reduction in seizures became SD ≧ 2 years postresection. No case with < 90% seizure reduction at one year showed improvement with longer follow-up.
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