lntractable Temporal Lobe Epilepsies; Surgery, Pathology and Postoerative Prognosis

Abstract

Purpose: Anterior temporal lobectomy is the most frequently performed epilepsy surgery worldwide. Most epilepsy centers require an intensive presurgical assessment using neuroimaging tests and longterm, in patient video/EEG monitoring to confirm the brain region of seizure onset. Methods: Fifty eight patients, who was thought as temporal lobe epilepsy (TLE) clinically, were monitored in Gazi University Medical Faculty Telemetry Center. The interictal EEG, ictal EEG, behaviour of patients during the seizures were evaluated. All of the patients had cranial MRI Results: Fifty one patients were diagnosed as TLE at the end of monitorization. Fourty one of them had one epileptogenic focus in the scalp EEG monitorization. Seven patients were also monitored by using subdural strip electrodes and in five of them the brain region of seizure onset was determined. Twenty five patients underwent Anterior temporal lobectomy + amygdalohippocampectomy (ATL+AH) in Ankara University Medical Faculty Neurosurgery department and twenty four of them were seizure free in their follow up. Hippocampal sclerosis was confined pathologically in eighteen patients. Discussion: TLE is the most common type of intractable partial epilepsy amenable to surgery. Prediction of succesfull outcome ranges from %62-96 in published studies. In our study this ratio is %96