Abstracts

RATIONALE: For patients with frontal lobe epilepsy (FLE), outcomes following resection for those with lesions have been reported to be better than for those without an identifiable lesion. Our experience is reviewed here. METHODS: Of 85 surgeries for medically intractable epilepsy at the University of Maryland from 1993 to 1999, 16 were for the treatment of FLE in 13 patients. Presurgical evaluation included video-EEG with scalp electrodes and brain MRI in all patients. Intracarotid amobarbital testing and invasive monitoring were performed if indicated. The posterior margin of the resection was directed by cortical mapping with resection of both cortical and subcortical tissues. Patients with lesions underwent lesionectomy, with further resection of surrounding cortical and subcortical tissue. Anterior corpus callosotomy was performed in two non-lesional patients. RESULTS: Of 13 patients, 7 had lesions and 6 did not. 1 non-lesional patient had 2 resections and 1 lesional patient had 3. Lesions included tumors (pilocytic astrocytoma, meningioma, DNT, oligodendroglioma), lesions from old trauma, and a prior abscess. The average follow up is 34.3 months, with a range of 14 to 72 months. Outcomes are summarized in the table according to Engels' criteria. CONCLUSIONS: In our series, nonlesional FLE was not a predictor for poor outcome following resection. Although the frequency of Class I and II outcomes are not as high as in our temporal resections, the number of favorable outcomes in this series suggests that resection in nonlesional FLE deserves full consideration.