Reoperation for epileptic patients: a report of 5 cases

Abstract

Objective To review the clinical diagnosis and treatment of 5 epileptic patients with failure of epilepsy surgery, to explore causes of failure, and to summerize related experiences and lessons. Methods Five cases (4 males and one female, age from 2 years and 7 months to 24 years) of epilepsy [3 cases with dysembryoplastic neuroepithelial tumor (DNT) and 2 cases with hippocampal sclerosis associated with cortical dysplasia (CD)] were reported. Failure of epilepsy surgery in 5 cases were retrospectively analysed. Results The causes of failed surgery for epilepsy in 5 patients were confirmed by reoperation. The causes of failure were related to incomplete removal of the lesion and (or) epileptogenic zone in 3 cases, incomplete removal of medial temporal lobe structure in one case, and epileptogenic zone localized wrong or not accurate in one case. Outcomes of reoperation with gama-knife treatment were satisfactory. Four cases achieved Engel I, and one case with Engel III. By the evaluation of Tan Qifu's standard, 4 cases were satisfactory, and only one case showed moderate improvement. Conclusion The causes of failed epilepsy surgery may be related to incomplete resection of epileptogenic lesion. After failure it is necessary to present second preoperative evaluation and to perform reoperation which may produce satisfactory effect.

DOI：10.3969/j.issn.1672-6731.2011.04.009