Results of lesional vs. nonlesional frontal lobe epilepsy surgery

Fifty-three seizure focus resections limited to the frontal lobe were performed, Forty-nine lad adequate follow-up, Five of 17 (29%) nonlesional (NL) cases and 21 of 32 (66%) lesional (L) cases were seizure free (SF) at 1 year postoperatively, Eight of 9 (89%) L cases less than or equal to 18 years old vs, 13 of 23 (57%) > 18 years old were SF, Eight of 10 (80%) tumor vs, 13 of 22 (59%) nontumor L cases were SF, Sixteen NL cases were localized by invasive recording, Five (31%) were SF, Ictal localization was obtained in 4 of 32 L cases, Three of 4 (75%) were SF, Eighteen of 28 (64%) L cases without ictal localization were SF, Nine of 12 (75%) lateral resections, 7 of 12 (58%) lobectomies, and 2 of 13 (15%) mesial resections were SF, Three of 20 cases with at least 90% reduction in seizures became SD greater than or equal to 2 years postresection. No case with <90% seizure reduction at one year showed improvement with longer follow-up.