Surgery for refractory epilepsy caused by non -posttraumatic encephalomalacia

Objective To analyze the strategy and outcome of complete lesion resection (CLR) and multiple subpial transaction (MST) for epilepsy caused by non - posttraumatic encephalomalacia.Methods 28 cases were treated with CLR and MST according to preoperative magnetic resonance image (MRI), positive (PET) and 128 - led long - term video EEG. They were followed up for more than 1 year,and their outcome was graded by Engel scales for analysis. Results Grade Ⅰ was observed in 6 cases and Grade Ⅱ in 11 cases, Grade Ⅲ in 9 cases and Grade Ⅳ in 2 cases. Satisfactory seizure control was found in patients with localized encephalomalacia, or far away from eloquent area, or without brain atrophy, more than 80%. Conclusion CLR combined with MST is effective and safe for epilepsy caused by nonposttraumatic encephalomalacia. And the cases with localized encephalomalacia, or far away from eloquent area, or without brain atrophy are likely to have a better outcome. Key words: Encephalomalacia; Epilepsy; Surgical procedures,operative