Effects of stereotactic operations in the treatment of epilepsies--neurological aspects.

In 81 patients with intractable epileptic seizures 121 stereo-electroencephalographic (SEEG) examinations and 91 operations with stereoencephalotomy (SET) were carried out. SEEG and SET targets were chosen in 22 different subcortical structures and in the medial frontal cortex. In 6 of 18 temporal epilepsy cases SET was followed by classical hippocampectomy. With the exception of temporal lobe cases all others were unsuitable for classical neurosurgery. Of 61 controlled patients 24.5% were cured or greatly improved cured, 39.5% improved and 36% unimproved; Correlations among the clinical, EEG and SEEG findings; SET and therapeutic effects are discussed together with the role of stereotactic procedures. In our experience (Cigánek 1962) among patients unsuccessfully treated by conservative methods over 60% are unsuitable for classical procedures based on the criteria of the Montreal neurosurgical school, because of the absence of leading epileptogenic area or because they represent cases with completely or almost completely generalized seizures. In these cases stereotaxy offers prospects diagnostic refinement and treatment.