Abstracts

Rationale: Surgical resection of sensorimotor cortex can result in worthwhile seizure improvement in carefully selected adult patients with intractable epilepsy. This is the first review of epilepsy surgery involving the sensorimotor cortex in a predominantly pediatric population. Methods: Patients were identified from the epilepsy surgery database at the Miami Children’s Hospital. Those included had surgery for intractable epilepsy (corticectomy, lesionectomy, partial lobectomy +/- multiple subpial resections), in any portion of the sensorimotor cortex (pre and post-central gyrus). Patients with surgery extending to contiguous regions were included, however large lobar or multilobar resections extending outside of the sensorimotor strip were excluded. Patients with progressive neurological syndromes/malignant tumors were excluded. Results: Thirty-six patients were identified. Patient pre-operative details and data from surgery are displayed in the tables. Average age at surgery was 9.6 yrs (6 months-24.5 years). Five patients had repeat surgery in the sensorimotor region due to ongoing seizures and no worthwhile improvement (<50% reduction of seizures) from first surgery. Repeat surgery was performed at an average time of 7.8 months following the first procedure (range 1-17 months). 34 patients had available follow up data at least 1 year from the time of final surgery (1-13 years, mean 5). Following final surgery involving sensorimotor cortex, 15 patients (44%) were seizure free, with 7 (21%) showing 90% improvement. 4 patients had >50 % improvement in seizures, with 7 (19%) having no worthwhile improvement. Conclusions: Relatively high seizure freedom and worthwhile seizure outcomes can be obtained from resection in the sensorimotor cortex in children.