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Patients with drug resistant epilepsy are potential candidates for surgery. The pre surgical study of these patients involves a multidisciplinary approach.We included patients who had been submitted to EEG video monitoring in our centre (a tertiary university hospital) between April 1995 and May 2000. The evaluation protocol included magnetic resonance (MR) brain scan (according to a specific protocol), neuropsychological and psychiatric evaluation, and ictal/interictal SPECT, when possible. Patients who underwent surgery were followed up at regular intervals until at least two years after surgery.Of the 299 patients with EEG video monitoring, 87 had been submitted to surgery up to June 2000. Nine of these patients required invasive subdural studies or studies of the foramen ovale using electrodes. Of the patients who underwent surgery, 44.8% had sclerosis of the hippocampus in the MR and in 10% it was found to be normal. The results of pathological anatomy revealed: 49.3% with sclerosis of the hippocampus, 15.1% with benign tumours, 13.7% with gliosis, 4.1% heterotopias and 4.1% cavernomas. Just one patient has been submitted to surgery again because of badly controlled seizures. Eight patients have presented post surgical complications (four with permanent morbidity). Of the 73 patients who were followed up for at least a year, 83.6% are in Engel class I, 9.6% in class II, 2.7% in class III and 4.1% in class IV. Among patients who underwent a temporal resection, 88.7% were in class I and 0% in class IV.Epilepsy surgery, in selected patients, has a very low morbidity/mortality rate and the chances that seizures will disappear or greatly improve are high.

A series of 24 small cell nasal tumors with neuroendocrine differentiation was studied by electron microscopy, and the numbers of secretory granules and cell junctions were assessed. To investigate the relationship between the extent of dendrite formation and the behavior of the tumors, the size of the tumor cells and the area occupied by dendritic processes were determined for each tumor by morphometric analysis performed on low-magnification electron micrographs. A positive correlation was demonstrated between the dendritic area index and the survival of the patients (P = 0.017). Neither the number of secretory granules nor the frequency of cell junctions was prognostically significant.