Type I/II complex partial seizures: no correlation with surgical outcome

Three complex partial seizure (CPS) types have been described based upon the behaviors seen at the onset of the ictal event. Type I CPSs are preceded by a motionless stare and have been correlated with a temporal focus, whereas Type II CPSs are not preceded by a motionless stare and have been correlated with an extratemporal focus. A third type of CPS, temporal lobe syncope, has been correlated with bilateral mesial temporal foci. We examined the utility of this CPS classification system in predicting surgical outcomes by reviewing our patients who had undergone surgical excision of their epileptogenic foci for the treatment of medically refractory CPSs. Forty-six consecutive patients were evaluated, with the seizure focus ultimately found to be temporal in 41 and frontal in 5. All 5 patients with frontal foci had Type II CPSs; of the 41 patients with temporal foci, 20 had Type I and 21 had the Type II CPSs. Twenty of 26 patients with Type II CPSs and 18 of 20 patients with Type I CPSs had a good or excellent outcome. Although our data suggest that patients with frontal foci have Type II CPSs, the reverse is not true. Furthermore, CPS type is not correlated with the surgical outcome, since there was no significant difference between the CPS type and the category of surgical outcome.