[Clinical analysis of reoperation in cases of complex partial seizures]

Of a series of 526 cases of surgically treated refractory epilepsy, 387 cases were patients with complex partial seizures. Among 118 cases who had no improvement by the first operation, to prevent partial seizures, 20 patients underwent reoperation. Of the 20 patients, 12 (60%) were men. The mean age at the first operation was 21.7 years. A retrospective analysis of clinical findings, successive EEG findings, psychological studies, surgical findings and surgical treatment of these patients were made. Following the first operation, complex partial seizures reappeared within a mean period of 5.5 months. And the mean period from the first operation to the reoperation was 4.9 years. Following reoperations, 6 patients (30%) became seizure-free, 3 patients (15%) had a remarkable reduction of seizures and 7 patients (35%) had worthwhile improvement. But 4 patients (20%) had no improvement. Histopathological study of the resected hippocampus revealed gliosis in 16 patients (80%). The indication for and procedures of reoperation were discussed.