Location of epileptogenic focus and selection of appropriate surgical methods in treatment of post-traumatic epilepsy

Objective To evaluate the efficacy of combined various surgical procedures for the treatment of post-traumatic epilepsy.Methods According to the preoperative primary location of epileptogenic focus and the monitoring results of intraoperative electrocorticography and depth electrodes,21 seizure patients were treated with various surgical procedures: 7 cases with epileptogenic focus resection,8 cases with epileptogenic focus resection combined with multiple subpial transection(MST),4 cases with anterior temporal lobectomy combined with amygdalo-hippocampotomy,1 case with selective amygdalo-hippocampotomy under neuronavigation,and 1 case with anterior callosotomy combined with MST and bipolar coagulation on funtional cortexes. Results All the patients were followed up from 3 months to 10 years postoperatively,and the surgical outcomes were such as the followings: satisfactory outcome in 9 cases(42.9%),marked improvement in 7 cases(33.3%),improvement in 3 cases(14.3%),slight improvement in 1 case(4.8%) and no improvement in 1case(4.8%).There was no died cases caused by the surgical procedures.Eight patients had temporary dysfunction after operation,but all recovered in four weeks after surgery.Conclusion The combined various surgical procedures are effective and safe for the treatment of post-traumatic epilepsy.