Surgical Result of the Supplementary Sensorimotor Area Seizure

ABSTRACT

OBJECTIVE: The authors report the operative methods and postoperative outcomes of 14 cases with intractable supplementary sensorimotor area(SSMA) seizures. METHODS: From September 1996 to July 2001, 14 intractable cases treated by operation were reviewed and analysed with the help of each clinical characteristics, magnetic resonance images, histopathologic findings, noninvasive and invasive electroencephalographies(EEG), subdural grid and strip insertion and intracranial electrocorticographies and brain mapping results, retrospectively. The follow-up duration was from 2 months to 70 months(average, 26 months). RESULTS: There were eight males and six females and the age ranged from 2 to 47 years(average, 26.2). In the MRI findings, six lesional and eight nonlesional cases, and there were six localized and eight lateralized cases in the semiology and noninvasive EEG studies. In the histopathologic findings, cortical dysplasia was eight cases, gliosis three cases, leukomalacia one case and normal finding was two cases. In the seizure outcome, Engel's class I was 71.4%, class II was 21.4% and class III was 7.2%. The postoperative neurologic deficits were 12 in 14 cases and nine in 12 cases were dramatically improved within two or three weeks postoperatively and the remained three cases, the lesion was involved in the eloquent area but, all of them were improved via the rehabilitation programs. CONCLUSION: In the intractable SSMA seizure, the surgical treatment is an excellent method of treatment and early transient postoperative neurologic deficits were dramatically improved within several weeks.