OBJECT: Surgical treatment options for intractable @entity410 caused by a nonlesional epileptogenic focus located in the central sulcus region are limited. The authors describe an alternative surgical approach for treating medically refractory nonlesional @entity302 . METHODS: Five consecutive @entity1 who were treated between 1996 and 2000 for nonlesional partial @entity302 that had originated in the central lobule were studied. The @entity1 ' ages ranged from 16 to 56 years (mean 28.6 years; there were four @entity1 and one @entity1 ). The duration of their @entity302 ranged from 8 to 39 years (mean 20.2 years), with a mean @entity410 frequency of 19 partial @entity410 per week. Preoperative assessment included video electroencephalography (EEG) and subtracted ictal-interictal single-photon emission computerized tomography coregistered with magnetic resonance imaging (SISCOM). @entity1 underwent an awake craniotomy stereotactically guided by the ictal EEG and SISCOM studies. Cortical stimulation was used to identify the sensorimotor cortex and to reproduce the @entity1 's aura. A subdural grid was then implanted based on these results. Subsequent postoperative ictal electrocorticographic recordings and cortical stimulation further delineated the site of @entity410 onset and functional anatomy. During a second awake craniotomy, a limited resection of the epileptogenic central lobule region was performed while function was continuously monitored intraoperatively. One resection was limited to the precentral gyrus, two to the postcentral gyrus, and in two the excisions involved regions of both the pre- and postcentral gyri. In three @entity1 a @entity1269 occurred postsurgery but later resolved. In the four @entity1 whose resection involved the postcentral gyms, transient cortical sensory loss and @entity1742 occurred, which completely resolved in three. Two @entity1 are completely @entity410 free, two have experienced occasional nondisabling @entity410 , and one @entity1 has benefited from a more than 75% reduction in @entity410 frequency. The follow-up period ranged from 2 to 5.5 years (mean 3.5 years). CONCLUSIONS: A limited resection of the sensorimotor cortex may be performed with acceptable @entity16 in @entity1 with medically refractory @entity302 . This procedure is an alternative to multiple subpial transections in the surgical management of intractable nonlesional @entity302 originating from the sensorimotor cortex.

Nonlesional central lobule @entity410 : use of awake cortical mapping and subdural grid monitoring for resection of XXXX focus.

@entity1 :: ('9606', 'Species') :: ['Patients', 'woman', 'patients', 'patient', 'men'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure', 'seizures'] @entity1269 :: ('MESH:D010291', 'Disease') :: ['hemiparesis'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological morbidity'] @entity302 :: ('MESH:D004827', 'Disease') :: ['perirolandic epilepsy', 'epilepsy'] @entity1742 :: ('MESH:D001072', 'Disease') :: ['apraxia']
@entity410 :: (MESH:D012640,Disease) :: ['seizure']
