Outcomes after Temporal Lobectomy for Temporal Lobe
Epilepsy with Hippocampal Sclerosis
Teeradej Srikijvilaikul MD*, Sukulya Lerdlum MD**,
Supatporn Tepmongkol MD**, Shanop Shuangshoti MD***
Affiliation :
* Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
** Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
*** Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : Outcome predictors from the pure cohorts of patients with temporal lobe epilepsy (TLE) with hippocampal
sclerosis (HS) are limited. The aim of the present study was to assess seizure outcomes and predictive factors in groups of
well-defined patients with TLE-HS.
Material and Method: One hundred forty eight patients with drug resistant TLE who had magnetic resonance imaging
(MRI) that demonstrated unilateral HS underwent temporal lobectomy between 2004 and 2008 by a single neurosurgeon.
All patients had completed at least two years of follow-up. Seizure outcome was categorized into seizure-free and not
seizure-free.
Results : Ninety-five patients (64.2%) were seizure-free after surgery at two years of follow-up. At four years follow-up,
47 patients (77.1%) were seizure-free for at least two years. There was no operative mortality or significant morbidity.
No clinical variables are predictive of surgical outcomes at two and four years of follow-up.
Conclusion : Temporal lobectomy for drug-resistant TLE with HS is safe and effective. The authors did not identify predictive
factors of surgical outcomes in TLE-HS.
Keywords : Hippocampal sclerosis, Temporal lobe epilepsy, Drug resistant epilepsy surgery, Temporal lobectomy, Outcome,
Predictors
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