Primary Article

Epilepsy Surgery: Removing the Thorn From the Lion's Paw

Authors: KATHRYN L. HOLLOWAY MD, W STEPHEN CORRIE MD, EDWIN C. WINGKUN MD, MICHELE H. JOHNSON MD, A JOHN KUTA MD

Abstract

ABSTRACT: In the United States, 10,000 to 20,000 patients have epilepsy uncontrolled by medication. The addition of a second-line drug to the primary regimen has a 2% to 11% chance of controlling the seizures. We present a series of 35 patients with intractable epilepsy who had surgical resection of their seizure focus. Seventy-five percent of the patients with temporal lobe epilepsy were made seizure free, with an additional 14% sustaining a greater than 90% reduction in seizures (decrease in number and frequency). Seventy-one percent of the patients with extratemporal lobe epilepsy (seizures originating outside the temporal lobe) had a worthwhile reduction (>90%) in their seizures. Two patients sustained permanent clinically significant deficits as a result of their presurgical evaluation or resection. There were no deaths. Epilepsy surgery offers a cure for the “incurable” patient with a morbidity of 5% to 6%.

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