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Post-traumatic frontal lobe epilepsy with structural changes: excellent results after cortical resection
A Cukiert1, A Olivier, F Andermann
1Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
Summary
Resecting frontal lobe lesions effectively treats intractable epilepsy. Modern imaging and surgery offer excellent seizure control for patients with post-traumatic epilepsy.
Area of Science:
- Neurosurgery
- Epileptology
- Neuroradiology
Background:
- Surgical resection of frontal lobe lesions has been a known treatment for intractable epilepsy for over 60 years.
- Modern diagnostic and operative technologies enhance the effectiveness of these resections.
- The full potential of these advanced techniques is not widely appreciated by clinicians.
Purpose of the Study:
- To review the outcomes of resecting large post-traumatic frontal lobe lesions in patients with intractable epilepsy.
- To highlight the utility of modern imaging in identifying these lesions.
- To emphasize the efficacy of surgical intervention for post-traumatic epilepsy.
Main Methods:
- Retrospective review of six patients with intractable frontal seizures.
- Surgical resection of large post-traumatic frontal lesions.
- No invasive electroencephalogram (EEG) recordings were used pre-operatively.
Main Results:
- Imaging characteristics of post-traumatic lesions, often from depressed skull fractures, were illustrated.
- Five out of six patients became seizure-free after surgical treatment.
- The remaining patient experienced over an 85% reduction in seizure frequency.
Conclusions:
- Modern imaging techniques allow for clear visualization of post-traumatic lesions causing intractable seizures.
- Resection of these traumatic scars typically results in excellent seizure control.
- Surgical treatment is a highly effective option for intractable post-traumatic epilepsy.