Posterior quadrant disconnection surgery for intractable epilepsy in temporoparietooccipital lobe: a report of three cases

Abstract

Objective To discuss the effect of posterior quadrant disconnection surgery on temporoparietooccipital intractable epilepsy. Methods A retrospective review of clinical, neuropsychological, EEG, imaging and histopathological data of 3 patients with intractable epilepsy, admitted to and underwent posterior quadrant disconnection surgery in our hospital from February 2012 to October 2013, was performed. Results The clinical manifestations of 3 patients were simple partial seizures generalized seizures secondary to partial seizures and generalized tonic clonic seizures. MRI examination showed that 3 patients were porencephaly, white matter dysplasia, and gray matter heterotopia. Patients were treated with right posterior quadrant disconnection surgery after general anesthesia. Follow up of 32, 12 and 29 months was respectively performed in these 3 patients. The seizure control result after surgery was Engel I in 2 patients and Engel II in one patient. There was no new prolonged neurological deficit or death. Conclusion Posterior quadrant disconnection surgery is an effective method for posterior quadrant intractable epilepsy, which results in similar excellent early seizure control as hemispherectomy. Key words: Intractable Epilepsy; Posterior quadrant disconnection surgery; Temporoparietooccipital lobe; Occipital lobe