Long-Term Seizure Outcome after Temporal Lobectomy for Hippocampal Sclerosis
Teeradej Srikijvilaikul MD1,2, Chusak Limotai MD3,4
Affiliation : 1 Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand 2 Prasat Neurological Epilepsy Center, Prasat Neurological Institute, Bangkok, Thailand 3 Chulalongkorn Comprehensive Epilepsy Center of Excellent, The Thai Red Cross Society, Bangkok, Thailand 4 Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To study long-term seizure outcomes in patients with temporal lobe epilepsy [TLE] with hippocampal sclerosis [HS].
Materials and Methods : One hundred twelve patients with drug resistant TLE underwent temporal lobectomy and had pathologically
proven HS between 2004 and 2008. All patients had a minimum follow-up of (cid:976)ive years. Seizure outcome was categorized into being
seizure-free and not seizure-free.
Results : Sixty one patients (54.5%) were seizure free for the entire period after surgery. One hundred patients (89.3%) were seizure
free for at least two years at the last follow-up. Forty three patients (38.4%) were able to stop antiepileptic medications. The mean
follow-up was 8.1±1.9 years (range 5 to 11 years). A preoperative secondarily generalized tonic-clonic seizure was predictor for
poor seizure outcome.
Conclusion : A long-term outcome (more than (cid:976)ive years) in terms of a percentage of seizure free in TLE with HS [TLE-HS] patients
remains favorable. Long-term seizure outcome is helpful for preoperative and postoperative counseling to the patients. Surgical
treatment should be considered in patients with drug-resistant TLE-HS.
Keywords : Hippocampal sclerosis, Temporal lobe epilepsy, Temporal lobe surgery, Epilepsy surgery, Seizure outcomes
