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Surgical Treatment of Children with Medically Intractable Frontal or Temporal Lobe Epilepsy: Results and Highlights of 40 Years' Experience
Author(s) -
Fish David R.,
Smith Shelagh J.,
Quesney Luis F.,
Andermann Frederick,
Rasmussen Theodore
Publication year - 1993
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1993.tb02405.x
Subject(s) - epilepsy , temporal lobe , etiology , medicine , abnormality , frontal lobe , epilepsy surgery , surgery , lesion , central nervous system disease , pediatrics , psychiatry
Summary: Etiologic, pathologic, and clinical features of possible prognostic significance were studied in 118 children who underwent frontal or temporal lobe epilepsy surgery at the Montreal Neurological Institute (MNI) between 1940 and 1980 (excluding tumor cases). Mean age of seizure onset was 5.1 years (range 0–12 years), mean age at operation was 11.7 years (range 0.6–15 years), and median duration of follow‐up was 15 years (range 2–31 years). Thirteen of 45 frontal surgery patients and 43 of 73 temporal surgery patients had an excellent outcome. In the frontal surgery group, this was restricted almost entirely to patients with an established etiology, particularly if this included a circumscribed resectable structural abnormality. In the temporal surgery group, a history of early, prolonged febrile seizures was usually associated with good outcome, unless there was additional evidence of extratemporal epilepsy. In the entire series, the presence of a nonresectable structural lesion or secondarily generalized seizures was associated with a poor outcome.