Abstracts

To explore the possible factors affecting the surgical outcomes in patients with intractable epilepsy, to summarize the experiences of resecting the epileptic foci and/or combinning with bipolar-coagulation methods.
In 204 patients, male were 130 cases and female 74 . The age ranged from 3 to 51 years old and age less than 18 years old was group I and the others group II . MRI, EEG and V-EEG were used as pre-operative evaluations for all patients. 12 cases were treated with purely bipolar-coagulation on the epileptic discharges areas, 7 cases with corpus callosotomy plus bipolar-coagulation, 9 cases with hemispherectomy and 176 cases with lesionectomy and /or epileptogenic foci resection plus bipolar-coagulation. Patients with temporal lobe epilepsy (TLE) were 100 cases and extra-TLE 42 cases (25 in frontal, 12 in parietal and 5 in occipital) and multiple lobes epilepsy 162 . All patients were followed-up by mail, phone annually since 1996.The factors including the sex, age, epileptogenic reasons, epileptic sites, operative fashions, follow-up times would be analyzed.
The general surgical outcomes: 68.63%(140/204) were seizure free (Engel I), and Engel II 14.71%(30/204), Engel III 8.82%(18/204), Engel IV 7.84% (16/204). In male and female patients, the seizure free ratio was 63.08% and 78.38% respectively (p[lt]0.05). In younger patients, the seizure free percentage was 79.59% and older 58.49%. 140 cases could be found abnormal structures in MRI scans and 91 cases were cured, 64 cases had negative MRI imagines with definite clinical manifestations and positive eletrophysiological examinations and 49 cases were seizure free. The TLE seizure free ratio was 73%(73/100) and extra-TLE in frontal, parietal and occipital lobe were 68%(17/25), 91.67%(11/12), 80%(4/5) respectively and multiple lobes 56.45%(35/62). As for as the follow-up durations: the seizure free percentage of follow-up 6 to 7 years, 5 to 6 years, 4 to 5 years, 3 to 4 years, 2 to 3 years, 1 to 2 years were 63.64%(7/11), 100%( 9/9), 77.27% (17/22), 61.54% (24/39), 68.75% (33/48), 66.67% (50/75) respectively. 6 (50%) of 12cases with purely bipolar-coagulation were seizure free and 3 (42.86%) of 7 cases with corpus callosotomy plus bipolar-coagulation and 9 case with hemispherectomy were completely seizure free. 125 (68.31%) of 162 cases with multiple lobe epilepsy were cured.
Factors such as sex, age has a little role in determining the prognosis. Patients with secondary epileptogenic reasons have s better outcome than primary patients, but there is no significantly differences. Patients with single cerebral lobe epileptogenic foci have a better result than patients with multiple lobes. Among all patients, hemispherectomy has the best results in controlling the attacks and combined operations are better than singles.The group of 5 to 6 years follow-up durations is better than the others group for owning a little cases.