| Analysis of Long-Term Surgical Outcomes in Adult Patients with Medically Intractable Temporal Lobe Epilepsy |
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Wan-Soo So, Seung-Soo Park, Ki-Hun Kwon, Eun-Jeong Koh, Ha-Young Choi |
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Department of Neurosurgery, Chonbuk National University Medical School and Hospital, Jeonju, Korea |
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| Abstract |
Objective
We analyzed to know surgical outcome of patients with intractable temporal lobe epilepsy undergone epilepsy surgery
in Chonbuk National University Hospital. Materials and Methods: This study included 116 adult patients who underwent epilepsy surgery due to intractable epilepsy between January 1997 and June 2005. Preoperative evaluations were history taking, neurologic examination, semiologic analysis with prolonged video-EEG monitoring with surface, depth, and subdural grid electrodes, brain MRI, 3D-surface rendering, functional neuroimaging studies, neuropsychologic test, and Wada test. Operation methods consisted of standard temporal lobectomy with amygdalohippocampectomy, corticoamygdaloidectomy with sparing of hippocampus, extended temporal lobectomy, and lesionectomy. Histopathologic diagnosis was done in all the specimens. Postoperative seizure outcomes were evaluated by Engel's classification. Average follow-up period was 57 months.
Results
Among the 116 temporal lobe epilepsy patients, 91 patients had standard temporal lobectomy, 6 patients underwent corticoamygdaloidectomy, 7 had extended temporal lobectomy, and 12 patients had lesionectomy. Out of 116 temporal lobe epilepsy patients, the number of Engel class I, II, III and IV were 109, 6, 1, and 0, respectively. Postoperative complications were transient hemiparesis in standard temporal lobectomy.
Conclusion
Meticulous MRI, functional image, semiology and electroencephalogram (EEG) analysis can lead to localize the epileptogenic zone. Epilepsy surgery according to preoperative evaluation results have a good outcomes in seizure control in patients with intractable temporal lobe epilepsy. |
| Key Words:
Temporal lobe epilepsy, Epilepsy surgery. |
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