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Posterior cortex epilepsies encompass epilepsies originating from occipital, parietal, and/or posterior temporal lobes. When seizures are refractory to pharmacologic treatment, patients are usually referred for surgery. The aim of our study was to analyze the short and long term seizure outcomes of children who underwent posterior epilepsy surgeries.

Retrospective data on 22 patients who underwent posterior epilepsy surgeries (lesionectomy, lobectomy, multilobectomy and disconnection) between 1998 and 2008, with at least 5 years follow up, were collected. Postoperatively, Engel classification was used for seizure short and long term outcomes.

Ages at surgery were between 2 and 18 years (mean 10.4), 15 (68.2%) male. Age at seizure onset was 3 years. Epilepsy duration varied from 1 to 18 years (mean 7.4). Concerning the etiology, 12 (54.5%) presented gliosis at the histopathology and 10 (45.5%) cortical/vascular malformation. In the first postoperative year, 16 (72.7%) patients were categorized as Engel I, 1 (4.5%) as Engel II, 3 (13.6%) as Engel III, and 2 (9.0%) as Engel IV. In the fifth postoperative year, 15 (68.2%) were Engel I, 2 (9.0%) Engel III and 5 (22.8%) Engel IV.

Surgical treatment is effective for seizure control in posterior cortex epilepsies. Nevertheless, up to now epilepsy surgery is considered treatment of last resort. Good seizure outcomes could be decisive in identifying as early as possible patients that could benefit from surgery providing seizure control, avoiding disability, dependence, and significant economic and personal costs.

Epilepsy; posterior quadrantic epilepsy; posterior epilepsy surgeries;