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Old 08-17-2017, 02:54 PM
jtk jtk is offline
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specifically: left frontal resection


Heya.

i've been trying to find people who have had a left frontal resection for epilepsy, specifically. i can only find the publications on seizure freedom and stats. what i'm looking for is people, post op. Not temporal, not right...left frontal.

i'm sitting on the fence with moving fwd with the surgery. My language is sitting right on the grey matter heterotopia (middle posterior gyrus) in my left lobe and my abstract problem solving etc is chillin riiiight there as well.

i've had my extended telemetry and all the fun stuff. initially they were keen to go for surgery and map in the or- but the surgeon isn't so keen, given my neuropsych results - my exec functions are within the normal range- but comparatively low, so bonus, i'll still have next to no filter, but no one will notice. the issue is in cognitive function aside from that. i scored above average and would see either a deficit or worst case, lose function.

i'm backed into a corner. i cannot possibly stay on meds. my life has zero quality. since accepting care, everything has ground to a halt. but i'm also dependent on the buggers now and was typical of clusters resulting in status before i got on them (23 yrs worth of seizures, they have defo gotten stronger- but i knew me and i was willing to live like that to have quality of life) no longer. so it's surgery or meds. rock, meet hard place.

i'm just looking for people who've had experience in any way specific to post op left frontal resections and what deficits if any, resulted. opinions- good, bad, fantastic etc. hit me. please. i can't find anyone who can relate without doing an apples to oranges temporal or right etc. any apples to apples out there?

38 female. adult onset (at 15) due to FAS- left frontal lobe middle posterior gyrus grey matter heterotopia- generalized structural abnormalities left cortical. left dominant. briviact 250mgs/clobazam 10mgs ativan sublingual as needed. auras, focals, tonic clonic's and status resulting in tonic clonic clusters- seizure free with meds bar auras and focals - co-morbid diagnosis, med resistant.
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Old 08-18-2017, 01:02 PM
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Hi jtk,

I didn't have a left frontal resection. I did have a left temporal resection when I was 32 years old. It wasn't successful so now I'm still on meds. However, here is an article pertaining to cognitive functions in frontal lobe epilepsy:

Quote :

https://www.ncbi.nlm.nih.gov/pubmed/9665644

The present study investigated the effect of frontal lobe surgery on "cognitive functions", which have previously been shown to be discriminative in the evaluation of non-resected patients with frontal lobe epilepsy (FLE). The cognitive outcome was evaluated with particular consideration of the side (left/right), the site (lateral, orbital, mesial, premotor/SMA), the type of surgery (resections vs. resections plus multiple subpial transections; MST), and seizure outcome. The evaluation is based on 33 patients with left (n = 17) or right (n = 16) frontal surgery. Forty-five patients who underwent successful left (n = 21) or right (n = 24) temporal lobectomy served as controls. The neuropsychological examination covered speed/attention, motor sequencing/coordination, response maintenance/inhibition, short-term memory, and language. With the exception of short-term memory, the chosen tests were discriminative in determining preoperative frontal lobe dysfunctions but they did not differentiate patients with a different lateralization or localization of the frontal focus. At the 3 month follow-up examination, patients with temporal lobectomy had improved frontal functions, whereas patients with frontal lobe surgery showed a mild deterioration. Within the frontally resected group, completely seizure-free patients had significantly improved short-term memory. Further consideration of the side, site and the type of the frontal resection indicated that patients with premotor/SMA surgery and patients with precentral/central MST had additional impairment after surgery. Premotor/SMA resections led to a deterioration in response maintenance/inhibition and if performed left sided also to deteriorated language functions. The latter impairment could be clearly related to transient aphasia directly after surgery. Irrespective of pareses observed immediately after surgery, patients with MSTs of the precentral/central areas displayed additional problems in motor coordination at the follow-up examination. In this group the seizure outcome was also less favourable. In summing up, frontal lobe surgery does not cause any considerable additional impairment in the short-term follow-up. However, caution is recommended when surgery or MST affect functional relevant cortex (here the prefrontal/SMA and precentral/central area). Finally, a release of functions associated with frontal areas not affected by surgery is suggested, when seizures are successfully controlled by surgery.
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Old 08-18-2017, 02:15 PM
jtk jtk is offline
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heya!

thanks for that. read the studies, unfortunately. i understand the risk and plausible outcome as well as fully getting that even if i spoke with someone apples to apples, it can never be. we are all as unique in our structure as we are in our epilepsy. it would just give me piece of mind (resection pun intended) to hear from someone who's had LFL surgery.

i'm sorry yours didn't go as planned. hopefully you're more tolerant to meds than my experience.
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