Surgical Treatment of Epilepsy: Preoccipital Coagulation.

Lee, Chu Kul

Original Article

Journal of Korean Neurosurgical Society 1972;1(1): 1-14.

Lee's Neurosurgical Hospital Su Pyo Dong, Chung Ku, Seoul, Korea.

ABSTRACT

Electrocorticograms were recorded in cases with cases with epilepsies following procainization and eletrocoagulation of limited areas of cerebral cortex. Procainizaion of preoccipital cortical area, Brodmann's area 19, causes suppression of epileptiform discharge in the rest or ipsilateral cerebral hemisphere, motor, sensory and temporal areas. Conversely no suppression of electrical activity was observed in preoccipital leads following procainization of motor, senory or temporal areas. Electrocoagulation of preoccipital area also produced a regression of the abnormal cortical activities in the motor, sensory and temporal areas, which was the phenomenon identical with that following procainization of preoccipital area, and lasted weeks and months along with clinical improvement in symptomatology of epilepsy. Fifty-one cases of intractable epilepsy were treated surgically by the coagulation of preoccipital areas which were exposed through skull trephine hole with perforator in D'Errico trephine. It was noteworthty to emphasize that progressive normalization of electroencephalographic records of patients was obtained in months or years after the preoccipital coagulation. The surgical treatment of epilepsy in fifty-one cases was associated with freedom from seizures in three cases and clinical improvement in thirty-none cases. The purpose of surgical intervention upon preoccipital area was mainly based on blocking and suppressing the abnormal excessive neuronal discharge passing or spreading through the preoccipital cortical area over the rest of ipsilateral cerebral hemisphere.