Resections for Extratemporal Epilepsy

Although patients with temporal lobe epilepsy have long been undergoing resections in an effort to achieve seizure freedom, those with extratemporal lobe epilepsy have not had the same experience. Extratemporal lobe epilepsy refers to any epilepsy arising from outside the temporal lobe, most commonly the frontal lobe, parietal lobe, occipital lobe, insula, perisylvian region, and perirolandic region. However, as technology advances, our ability to diagnose and treat epilepsy in these areas has become safer and more effective. One challenge that extratemporal lobe epilepsy provides is the diversity of seizure onset location and symptoms. These make both diagnosis and safe resection more difficult. With careful preoperative planning and precise surgical technique, patients with extratemporal lobe epilepsy can experience a significant reduction in seizures postoperatively with minimal morbidity. This chapter discusses the diagnosis, work-up, surgical technique, and outcomes associated with resections in the setting of extratemporal lobe epilepsy.