An Analysis of Results of Surgical Treatment of Epilepsy at National Epilepsy Center in Japan / 대한간질학회지

ABSTRACT

PURPOSE: The neurosurgical group of the National Epilepsy Center in Japan has been operating on epileptic patients for 17years. In recent 10 years, The 387 patients that have been operated on have enjoyed positive results. in this study, the authors will attempts to make a scheme for surgical treatment of epilepsy based upon the analysis of the patients who were treated with surgery METHODS: THe authors investugated the influenced of advanced in diagnostic procedures. In order to study the relationship between the previous disease and the histologic results, we divided the 152 temporal lobe epilepsy patients who received a resection of both medial temporal structure and lateral neocortex two groups those with hippocampal sclerosis and those with some other histologic finding. For analysis, patients were divided into 3 groups first, a lesional group second, a skip group that had no chronic intractanial recording third, an intracranial recording group. The results at 2 years, 5 years, 8 years, and 10 years after surgery were studied based on Engel's classification RESULTS & CONCLUSION: With the development of better diagnostic equipment, the incidences of epilepsy surgery have increased, while the percentage of the cases requiring invasive diagnostic procedure has been decreased overall. Not only have the cases of surgery for temporal lobe epilepsy increased but also for extratemporal epilepsy as well. Mesial temporal sclerosis and cortical migration disorder were the most common lesions requiring operative treatment. Febrile status epilepticus in childhood was the most common etiology of epilepsy found. Eighteen children among the twenty-three who had been operated were lesional cases. Longterm follow up studies up studies up to 10 years after surgery shows no worsening in patients condition based on Ecgel's grade of temporal lobe epilepsy.