The present study relates clinical and radiological data to histopathologic
al diagnoses in the first 139 patients (children and adults) in the Gotebor
g Epilepsy Surgery series. Temporal lobe resections were most common (54.0%
) followed by frontal lobe (18.0%) and multilobar resections (11.5%). All h
istopathological specimens were re-evaluated in connection with this study.
Parenchymal malformations and atrophic-gliotic lesions were the most commo
n histopathological findings. Microdysgenesis was more common than major ma
lformations (24.5% versus 11.5%). When the MRI scans were blindly re-evalua
ted the MRI findings correlated with histopathological diagnosis in all of
the vascular malformations, in 77.8% of the tumours, in 76.5% of the cases
with hippocampal sclerosis but only in 28.6% of the major cortical developm
Hemispherectomies carried the best seizure outcome prognosis followed by te
mporal lobe resections (75.0% versus 57.3% seizure free 2 years after surge
ry). Vascular malformations carried the best, and microdysgenesis the worst
prognosis (76.9% versus 39.4% seizure free).