Surgical Management of Extratemporal Epilepsy

Background: Surgery is a commonly established therapy option for pharmaco-resistant extratemporal epilepsies. Aim and objectives: To evaluate the clinical outcome of different surgical procedures for patients admitted to Al-Azhar Hospitals with drug-resistant extratemporal epilepsy. Patients and methods: We enrolled 15 patients with drug-resistant epilepsy in our prospective and retrospective study between June 20, 2022, and May 30, 2023. After their admission to the neurosurgery department at Al-Azhar University Hospitals, these patients underwent epilepsy surgery and underwent follow-up monitoring for six months. Results: The majority of the patients under study were female, with a mean age of 11.5±6.5 years, and 80% had a normal mentality. Eight cases (53.3%) presented generalized-onset seizures, three patients (20%) presented Jacksonian seizures, two patients (13.3%) presented focal seizures, one patient (6.7%) presented drop attacks, and one patient (6.7%) presented multiform presentations. Six patients (40%), 5 patients (33.3%), 1 patient (6.7%), and 3 patients (20%) underwent partial callosotomy, laminectomy, and combined technique. Four patients (26.7%) reported surgical complications. Eight cases (53.3%) achieved English class I. Three cases (20%) showed a rare, disabling seizure (Engle class II). One case (6.7%) achieved Engle class III, while three cases (20%) achieved Engle class IV (no improvement). Conclusion: Despite several obstacles, surgical treatment can successfully treat extratemporal lobe epilepsies, yielding satisfactory epileptological findings with manageable morbidity.