PARIETAL LOBE EPILEPSY: SURGICAL OUTCOME
Abstract number :
3.207
Submission category :
Year :
2002
Submission ID :
2893
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Chun Kee Chung, So Hee Kim, Sang Kun Lee. Neurosurgery, Seoul National University Hospital, Seoul, Korea; Neurosurgery, Seoul National University Hospital, Seoul, Korea; Neurology, Seoul National University Hospital, Seoul, Korea
RATIONALE: Parietal lobe epilepsy is not common, comprising less than 10% of large surgical series. To elucidate its characteristics and surgical outcome, the authors reviewed their surgical experience.
METHODS: Between September 1994 and August 2001, 36 patients with parietal lobe epilepsy received surgical treatment at Seoul National University Hospital. All the patients underwent resection involving the parietal lobe. Male to female ratio was 21:15. Ages ranged 4 to 38 (mean, 23 years). Preoperative evaluation included video-EEG monitoring, MR imaging, PET, SPECT, and Wada test. Preoperative diagnosis was variable; parietal lobe epilepsy was the most common (12/36, 33.3%), followed by lateral temporal lobe epilepsy (8/36, 22.2%), frontal lobe epilepsy (6/36, 16.7%) in decreasing frequency. Most common seizure type was complex partial seizure (24/36, 66.7%), followed by simple partial seizure (7/36, 19.4%). MR imaging revealed focal abnormality in the parietal lobe in 8/36 (22.2%). Postoperative follow-up duration ranged from 9 months to 66 months (mean; 41 months).
RESULTS: Invasive study was performed in 32 cases, among whom 10 cases received the second invasive study. There was no mortality. Transient neurological abnormality was observed in 5/36 (13.9%). However, it was recovered in one month postoperatively. Postoperative seizure outcome was as follows: 16 seizure-free, 1 rare seizure, 13 worthwhile improvement, and 6 no worthwhile improvement. Pathology was diverse, but the most common pathology was cortical dysplasia (28/36, 77.8 %).
CONCLUSIONS: Parietal lobe epilepsy is difficult to diagnose preoperatively. However, once diagnosed, it could be surgically treatable with reasonable risk.
[Supported by: Seoul National University Hospital]