Abstracts

RATIONALE: The relative risk for developing intractable epilepsy has been reported to be 6.9 times higher in patients with sutained head injury compared to an age-matched group(Annegers JF et al 1980). Our study investigates the incidence of mild to moderate head trauma in patients with intractable epilepsy, their pathology and surgical outcome. METHODS: We have reviewed the records of eighty five patients who underwent epilepsy surgery for intractable epilepsy in our institutation in regard to the history of mild to moderate closed head injury. The pathology and surgical outcome of patients with a history of head injury was studied and compared with the rest of the group. RESULTS: Eight of 85 patients had a history of mild to moderate head trauma(9.4%). The age at the time of head trauma varied from 5 to 24 years(mean 11.5) and the onset of seizures after head injury varied from 0 to 27 years(mean 8.75). In four patients the pathology was neoplastic( two gangliogliomas, two astrocytomas) with others consisting of ischemia 1, inflamation/gliosis 2, leptomeningeal fibrosis/gliosis 1 . Seven of eight patients had Engel class IA outcome and one, with grade II glioma and a history of meningitis in infancy had a class IIB outcome. CONCLUSIONS: In this study an incidence of 9.4% was found for head trauma in patients with intractable epilepsy. The pathology was variable but none disclosed typical mesial temporal sclerosis. The outcome was excellent in all patients except one who had a grade II glioma and history of childhood meningitis.