Multiple subpial transection: report of 7 cases

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 results are available at this time. In our series, we believe failures could be attributed to either a very restricted area of transection or to an incorrect delimitation of the epileptic focus.