Isolation of dominant seizure foci by multiple subpial transections

Arun Angelo Patil, Richard Andrews, Richard Torkelson

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Dominant seizure foci (DSF) are seizure foci that do not respond to multiple subpial transections (MST). DSF were isolated in 15/31 patients who underwent MST in the past 6 years. These patients had MST over both hemispheres (6 patients) or over multiple lobes of one hemisphere (9 patients). DSF measured 0.5-1 cm in diameter and numbered 1-4 (in each patient). Their excision resulted in dramatic improvement in EEG over wide areas of the cortex. The longest post-operative follow-up is 67 months, with a median of 21 months. Nine of 15 patients are free of seizures, 3/15 have rare seizures, 2/15 have >90% reduction in seizure frequency, and 1/15 has >70% reduction in seizure frequency with improvement in motor and speech functions. In summary, DSF are resistant to MST and influence the electrical activity of the surrounding cortex. MST combined with excision of DSF resulted in good seizure control in this series, which included patients with multilobar and bihemispheric seizure foci.

Original languageEnglish (US)
Pages (from-to)210-215
Number of pages6
JournalStereotactic and Functional Neurosurgery
Volume69
Issue number1-4
DOIs
Publication statusPublished - Dec 1 1997

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Keywords

  • Dominant seizure foci
  • Epilepsy surgery
  • Multiple subpial transections

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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