Effects of Stereotactic Lesions in Intractable Epilepsy

Two periods of surgical treatment of epilepsy can be distinguished before the stereotactic era. In the first period the preliminary data, the symptoms, and the careful seizure-observation constituted the basis of the focus-determination, the PEG confirmed, and the electric cortical-stimulations identified the surgical focus. In the second period the role of the scalp-EEG and electrocorticography (ECoG) came to the foreground. If the EEG focus coincided with the lesions determined by classical methods, then surgery needed to be considered even in cases of epilepsy controlled by anticonvulsants. In the case of psychomotor epilepsy associated with severe personality and behavioural disorders or predisposition to psychosis, we very often relied only on scalp-EEG. The stereo-EEG meant a further improvement of EEG as well as revising the localization value of scalp-EEG and our conception of epilepsy. An account of our observations concerning the stereo-EEG and the present significance of electrostimulation (ES) is reported in another paper (by Dr. Gombi and collab.). In this paper we shall deal only with the operative attempts.