Multiple subpial transection: report of 7 cases

Rougier, Alain; Sundstrom, Lars; Claverie, Bernard; Saint-Hilaire, Jean-Marc; Labrecque, Raymonde; Lurton, Dominique; Bouvier, Guy

Next »Epilepsy Research
Volume 24, Issue 1 , Pages 57-63, May 1996

Multiple subpial transection: report of 7 cases

Alain Rougier
- Corresponding author. Laboratoire de Neurobiologie et Neuro-Imagerie Expérimentales, Université de Bordeaux II, 146 rue Léo Saignat, BP 78, 33076 Bordeaux Cédex, France. Tel.: (33) 57-57-15-52; fax: (33) 56-51-52-48.
- Departments of Neurosurgery and Neuropsychology, Hôpital Pellegrin, Bordeaux, France
- Address reprint requests to: Professeur A. Rougier, Service de neurochirurgie. Hôpital Pellegrin. 33076 Bordeaux cedex France.
Lars Sundstrom
- Department of Physiology, University of Southampton, Southampton, UK
Bernard Claverie
- Departments of Neurosurgery and Neuropsychology, Hôpital Pellegrin, Bordeaux, France
Jean-Marc Saint-Hilaire
- Departments of Neurosurgery and Neurology, Hôpital Notre-Dame, Montréal, Quebec, Canada
Raymonde Labrecque
- Departments of Neurosurgery and Neurology, Hôpital Notre-Dame, Montréal, Quebec, Canada
Dominique Lurton
- Departments of Neurosurgery and Neuropsychology, Hôpital Pellegrin, Bordeaux, France
Guy Bouvier
- Departments of Neurosurgery and Neurology, Hôpital Notre-Dame, Montréal, Quebec, Canada

Received 8 October 1995; received in revised form 7 February 1996; accepted 9 February 1996.

Abstract

7 cases of pure multiple subpial transection (MST) without associated cortical resection, for treatment of pharmaco-resistant partial epilepsy localized in highly functional cortical area, are reported. The transections were performed following the technique described by Morrell. The follow-up period ranged from 1 to 4 years. MST induced no significant neurological handicap: only 2 patients experiencing a transitory sensory-motor deficit and with total recovery within 1 month. With respect to seizures, 5 patients were improved with a decrease in seizure frequency of 100, 95, 75, 60 and 40%, respectively. Complex partial seizures changed postoperatively into simple partial seizures in 1 case. In conclusion, this procedure seems to be adequate, although no statistically significant resutls are available at this time. In our series, we believe failures could be attributed either to a very restricted area of transection or to an incorrect delimination of the epileptic focus.

Keywords: Epilepsy surgery, Multiple subpial transection, Functional tolerance, Seizure effect

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