Surgery for epilepsy secondary to lesions within or near central sulcus

Abstract

Objective To study the surgical treatment of epilepsy secondary to lesions within or near central sulcus.Methods 35 patients with epilepsy secondary to lesions within or near central sulcus were reviewed retrospectively.The epileptogenic focus was located by EEG,dipole,electrocortieogram.The central salcus was Iocated by MRI.cortical somatosensory evoked potential and cortical electric stimulation.The lesions were resected along the cerebral sulcus by microsurgery.The cortical thermocoagulation of functional areas was used for residual epileptic waves.Result The patients were follow-aped from one year to three years.The follow-up results showed Engel Class I in 31 cases,Engel Class 11 in 4 cages.There was no one with Engel ClassⅢand IV.The neurological functions of patients were improved in 23 cases,unchanged in 7 cases,worsen in 10 cases at 3 month after surgery.There was no died patient.Conclusions Accuratelocalization of the epileptogenic focus and cerebral sulcus,mierosurgery under cortex and cortical thermocoagulation for residual epileptic waves could control the seizure effectively and avoid severe neurological impairments for patients with lesions located within or near central sulcus. Key words: Central sulcus; Lesions; Epilepsy; Microsurgery