Surgery for encephalomalacias presenting with intractable epilepsy

Abstract Surgery for intractable epilepsy caused by encephalomalacia (especially post-traumatic) has been reported very scarcely in the literature. 21 cases are presented who underwent resections for encephalomalacias for medically intractable epilepsy are presented from a series of 632 cases. Seizure duration pre-surgery ranged from 3 to 29 years (mean 7.8 years, median of 7 years). Seizure frequency ranged from 2 seizures/month to 7/day, with a median of 10 seizures/month. Causes included head trauma (9), encephalitis (2), peri natal ischemia (3) post abscess (3) and idiopathic (4). The postoperative follow-up was 21 months (ranging from 12 to 63 months). 17 had Engel’s Class I seizure outcome. Four patients had poor seizure outcome (two Class IV and two Class III). All post traumatic encephalomalacias had excellent outcome, and post encephalitis the worst. Encephalomalacia with intractable epilepsy have a varied outcome and depends on the pathology.