Surgical Result of the Supplementary Sensorimotor Area Seizure.

Chung, Tag Geun; Lee, Jung Kyo; Kang, Jung Gu; Kwang, Sang Am; Ko, Tae Sung; Khang, Shin Kwang; Kwun, Byung Duk

Original Article

Journal of Korean Neurosurgical Society 2002;31(5): 411-418.

Tag Geun Chung, Jung Kyo Lee, Jung Gu Kang, Sang Am Kwang, Tae Sung Ko, Shin Kwang Khang, Byung Duk Kwun

¹Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
²Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
³Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
⁴Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

ABSTRACT

OBJECTIVE
The authors report the operative methods and postoperative outcomes of 14 cases with intractable supplementary sensorimotor area(SSMA) seizures.
METHODS
From September 1996 to July 2001, 14 intractable cases treated by operation were reviewed and analysed with the help of each clinical characteristics, magnetic resonance images, histopathologic findings, noninvasive and invasive electroencephalographies(EEG), subdural grid and strip insertion and intracranial electrocorticographies and brain mapping results, retrospectively. The follow-up duration was from 2 months to 70 months(average, 26 months).
RESULTS
There were eight males and six females and the age ranged from 2 to 47 years(average, 26.2). In the MRI findings, six lesional and eight nonlesional cases, and there were six localized and eight lateralized cases in the semiology and noninvasive EEG studies. In the histopathologic findings, cortical dysplasia was eight cases, gliosis three cases, leukomalacia one case and normal finding was two cases. In the seizure outcome, Engel's class I was 71.4%, class II was 21.4% and class III was 7.2%. The postoperative neurologic deficits were 12 in 14 cases and nine in 12 cases were dramatically improved within two or three weeks postoperatively and the remained three cases, the lesion was involved in the eloquent area but, all of them were improved via the rehabilitation programs.
CONCLUSION
In the intractable SSMA seizure, the surgical treatment is an excellent method of treatment and early transient postoperative neurologic deficits were dramatically improved within several weeks.

Key Words: Supplementary sensorimotor area seizure; Localization; Lateralization; Seizure outcome