Surgery for Epilepsy Involving Rolandic and Peri-Rolandic Cortex

Abstract PurposeTo evaluate the risk factors associated with motor deficit following surgeries involving rolandic & peri-rolandic cortex and to introduce our surgical experiences dealing with lesions in this region.MethodsWe retrospectively reviewed patients who experienced drug-refractory epilepsies and received surgeries in our hospital. Medical records were carefully studied, and patients with lesions located in the rolandic & peri-rolandic cortex were screened. Those with detailed follow-up information were included. Lesion locations, resected regions, and invasive exploration techniques were studied to assess their relationship with the postoperative motor deficit.ResultsA total of 41 patients with lesions located in the rolandic or peri-rolandic cortex were included in this study. Of all these patients, 23 (56.10%) patients suffered from a transient motor deficit and 2 (4.88%) with a permanent disability after surgery. All eight patients with the anterior bank of precentral sulcus resected experienced motor deficit, and six of them gradually recovered within half a year. Seven patients with the anterior half of precentral gyrus resected did not experience permanent disability. A total of 14 (34.15%) patients received invasive exploration, and one of them had a permanent disability.ConclusionsThe anterior bank of the central sulcus is indispensable for motor functions, and the destruction of this region would inevitably cause a motor deficit. The upper part of the central sulcus could also be removed without significant neurological impairment if there is an epileptogenic lesion.