Stereotactic fields of Forel interruption for intractable epilepsy

Bilateral stereotactic fields of Forel surgery was carried out in 6 adults with chronic intractable epilepsy associated with multifocal EEG abnormalities. During an average 40 months follow-up, a significant reduction in the frequency of generalized tonic-clonic seizures was noted in 4 patients. Complex partial seizures in 3 patients and akinetic-myoclonic seizures in 1 did not respond to surgery. Neuropsychological testing revealed a mild to moderate postoperative cognitive decline in 4 patients. Fields of Forel surgery, while partially effective in generalized tonic clonic seizures, appears justified only in patients with such severe preexisting cognitive deficits, that the benefits of seizure control definitely outweight the risk of further cognitive decline.