Clinical study of using multiple operative methods for intractable epilepsy

Objective To evaluate the surgical outcome, we used epileptic focus resection alone or combining multiple operative methods to treat the patients suffering from the various kind of intractable epilepsy. Methods 80 patients suffering from intractable epilepsy were performed surgical treatment, thereinto 53 patients were treated by using multiple operative methods. The patients ranged from 6 to 50 years old (average 20 years old) with present history from 3 to 41 years old (average 17 years old). Different seizure patterns were observed in the candidates containing simple partial seizure, complex partial seizure and tonic-clonic seizure. All 80 patients had the preoperative examination of scalp video-electroencephalography (v-EEG) monitoring and magnetic resonance imaging (MRI), while 35 of them had single photon emission computed tomography (SPECT), 3 patients had positron emission computed tomography (PET) and 5 patients had magnetoencephalography (MEG). We had the following operational methods : 27 patients had local epileptic focus resection (LEFR), while 11 had LEFR plus multiple cortical subpial transsection (MST), 9 LEFR plus MST and brain cortical fever cauterization (BCFC), 33 patients had LEFR combined with MST, anterior temporal lobectomy (ATL) plus hippocampectomy and anterior corpus callosotomy. All the patients had been performed with the guidance of intraoperative electrocordicography (ECoG). Results Among 80 operative patients, no mortality occurred, however, two patients occurred hydrocephalus, one intracranial hemorrhage and one renal failure. Follow-up from 3 to 24 months were available for these patients. After operation they both have peroral administration of anti-epileptic drug.Clinical epileptic seizure for 51 patients were disappeared completely (63.8%), for 12 patients had significant improved than pre-operative(15.0%), however, 8 patients had effect partially(10.0%) , 6 patients had no satisfactory effect(7.5%) and 3 had no effect(3.8%). Total effective rate of the operation was 88.3%, while fineness rate was 80%. Conclusions Using multiple operative methods to treat the intractable epilepsy were safe and effective.