Surgical Pathologic Findings of Extratemporal-Based Intractable Epilepsy

Abstract Background.—Surgical management of intractable epilepsy continues to be important in select cases to achieve seizure control. Design.—This study retrospectively reviews the pathologic findings in 133 consecutive cases of extratemporal lobe epilepsy experienced during a 17-year period. Results.—The study group consists of 133 patients (78 males) who underwent extratemporal lobe resection for epilepsy at a mean age of 21.1 years (range, 3 months to 57 years). In 50 patients (37.6%), cortical dysplasia (neuronal migration abnormalities) was identified. The most common patterns of dysplasia observed included diffuse architectural disorganization in 46 cases, neuronal cytomegaly in 30 cases, increased numbers of molecular layer neurons in 30 cases, and balloon cells in 18 cases. Tumors were identified in 37 cases (27.8%) and included 13 astrocytomas, 7 gangliogliomas, 6 dysembryoplastic neuroepithelial tumors, 6 glioneuronal hamartomas, 4 oligodendrogliomas, and 1 oligoastrocytoma (mixed glioma). Twen...