Abstracts

Rationale: Although usually reserved for focal epilepsies, surgical treatment is occasionally utilized in cases of therapy-resistant generalized epilepsy. Surgery for generalized epilepsy is infrequently reported. We present our experience with surgical treatment of generalized epilepsy, including long-term outcomes. Methods: The Western Epilepsy Program Surgery Database was interrogated for all cases of surgically-treated generalized epilepsy. Consecutive cases, since the inception of the Epilepsy Program in 1977 until December of 2005, were included. The determination of the type of epilepsy was based on history as well as interictal and ictal findings on the EEG. MRI findings, type of surgery and outcome after surgery was analyzed. Patients were followed after surgery for up to 3 years. Results: A total of 1066 epilepsy surgeries were performed. We identified 31 cases of surgically-treated generalized epilepsy (15 females). The average age at seizure onset was 14 (range: 5 m to 20 y), the mean age at surgery was 30.1 years (range: 10-42y). Eleven cases were non-lesional. 8 cases required implantation of intracranial electrodes as there was concern about co-existence of focal epilepsy. Concomitant focal epilepsy was found in six. Twenty-six patients underwent corpus callosotomy only, 3 had corpus callosotomy and focal resections, 2 had hemispherectomy, and 3 cases had a focal resection. Three (10%) became seizure free after surgery (one focal resection and two callosotomies) at the last follow up (mean=13.2m, range 1-36m). Data about seizure types and their response to the surgical treatment will be presented. Conclusions: Although uncommonly performed, our experience indicates that surgical treatment for should also be considered for the treatment of medically-refractory generalized epilepsy in specific cases.