Presurgical evaluation. Preliminary analysis in a population of drug-resistent epileptic patients

F. Bisulli, A. Cerullo, P. Avoni, C. Marini, A. Baruz, P. Tinuper

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Objective We selected partial epileptic drug-resistent outpatients attending our Epilepsy Centre over the last ten years to evaluate the possibility of surgical treatment of epilepsy. Methods Diagnosis of partial epilepsy was made on the basis of anamnestic, neurophysiological and neuroradiological data. Seizure semeiology was accurately investigated. If the data were sufficient, patients were immediately referred to the neurosurgeon: if not, we admitted the patient to our Institute to record seizures. Results We studied 65 cases, 14 outpatients and 51 inpatients. Mean duration of hospital stay was 21.6 days. We recorded 1 seizure in 12 patients, from 1 to 5 in 15 and more than 5 seizures in 9 cases. We did not record seizures in 27 cases. 26 patients underwent epilepsy surgery: 17 only on the basis of our presurgical study and 9 after stereo-EEG evaluation. Our hypothesis of the epileptogenic zone was certain in 11 cases (side and lobe), less certain in 4 (side certain and lobe uncertain), not certain in 3 cases (neither side nor lobe), and only side certain in 2 cases. We judged 6 patients inoperable but they were referred to the neurosurgeon for an opinion. 39 patients were not operated on: 7 because they declined surgery, 20 are in stand-by, 6 were inoperable. Conclusion An appropriate and in-depth presurgical evaluation reduced the waiting time for surgery and avoided recourse to stereo-EEG for the majority of patients (65%) with a reduction in cost and less trauma for patients.

Original languageEnglish
Pages (from-to)346
Number of pages1
JournalItalian Journal of Neurological Sciences
Issue number5
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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