Abstracts

Although the frontal lobe epilepsies (FLE) are the second most common type of refractory epilepsy treated with surgery, the surgical outcome for FLE is invariably worst than that for temporal lobe epilepsy. The reasons for such outcome are still unknow. To address that we analyze the outcome of surgery for FLE and evaluate the impact that the surgery had on the patient[rsquo]s life.
We analyzed 60 adult patients from the Porto Alegre Epilepsy Surgery Program who underwent to surgical treatment for refractory FLE. All patients had surgical procedure on the frontal lobe. At least two years of follow up was considered to search the factors associated with a good or bad outcome. A questionnaire of quality of life was applied to these patients during the outcome examination. Frequency of seizures pre and post surgery was compared during the outcome. Evaluation of the ECoG pre and post resection and analyze of the area resected were performed for all patients.
We observed that the most conspicuous aspect associated with a good outcome was the absence of lesion remaining after the excision.
The factors more clear associated with a bad outcome were (i) the presence of abundant spiking in the postoperative ECoG, (ii) abnormal tissue left after resection.
The satisfaction of the patients with the surgery and improvement of the quality of life were associated with seizure frequency reduction.
Our results suggested that the presence of abundant spiking in the postoperative ECoG and abnormal tissue left after resection are aspects of poor outcome. Surgical treatment could provide a better quality of life for patients with refractory FLE.