gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Occipital lobe epilepsies and their surgical candidacy

Occipitallappenepilepsie und die neurochirurgische Bedeutung

Meeting Abstract

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  • corresponding author P. A. Winkler - Neurochirurgische Klinik, Klinikum Großhadern, München
  • C. Vollmar - Neurologische Klinik, Klinikum Großhadern, München
  • C. Erös - Neurochirurgische Klinik, Klinikum Großhadern, München
  • S. Noachtar - Neurologische Klinik, Klinikum Großhadern, München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-06.02

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Veröffentlicht: 4. Mai 2005

© 2005 Winkler et al.
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Recently more patients with intractable seizures emanating from outside the temporal lobe are being considered for possible surgery. Surgery in patients with occipital lobe epilepsy is more favoured, if they already have a visual field defect, which has been ascertained in the majority of cases. Since there is little information about this subgroup of localisation in the literature, we conducted the current study to gain experience with this generally small subgroup of surgical candidates.


Seven patients were selected for invasive presurgical evaluation and resective epilepsy surgery. All underwent grid implantation and consecutive video-EEG monitoring before planned resection. Five patients showed an incomplete homonymous hemianopsia before surgery. Patients who had both migraine headaches and a favourable response to antiepileptic therapy, which suggests a benign syndrome, were excluded from the invasive protocol.


Six of seven patients became completely seizure free. In three patients we observed a completion of the hemianopsia after surgery which had been expected. This deficit after complete resections of the occipital lobe was discussed in detail and explained to the patients and his/her relatives in advance. With a specially designed computerised training programme, all these patients were able to obtain a good quality of life. Microsurgery-related complications were not registered. Histopathology: six cortical dysplasias, one Sturge-Weber disease.


Contrary to the few reports in the literature of ca. 30% seizure freedom in patients with occipital epilepsies, the presented series showed a higher percentage (six of seven or 85%) of seizure cessation. The completion of the visual field deficit, which was in many cases preoperatively ascertained, could be improved with the above-mentioned visual field training. Partial resection of the occipital lobe and, in some cases, adjacent areas substantially reduces seizures in the majority of patients and allows therefore a significant improvement of the quality of life of these patients.