title: Temporal lobectomy in adults with intractable epilepsy.
abstract: We report on 30 adult patients with intractable complex partial seizure (CPS) of the temporal lobe origin who received anterior temporal lobectomy. The average follow-up period was 41 months. The age of onset was younger and the duration of epilepsy was longer in the non-mass lesion group than in the mass lesion group. Postoperatively, 21 patients (70%) were seizure-free, four patients (13%) had only rare seizures (less than three attacks per year), three patients (10%) achieved a remarkable reduction (more than 50%) of seizure frequency, and two patients (7%) showed no worthwhile improvement. Based on our experience, anterior temporal lobectomy is an effective and safe procedure for adult patients with intractable CPS. For diagnosis, magnetic resonance imaging (MRI) yielded a higher sensitivity rate than computed tomography (CT), especially in the group without mass lesions. Positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) was superior to single photon emission computed tomography (SPECT) which had a relatively high false localization rate. With high resolution MRI and FDG-PET, localization of the epileptogenic zone was more accurate. A preresection electrocorticogram (ECoG) was used to confirm the epileptogenic focus during the operation. The residual spikes on the postresection ECoG did not necessarily predict a poor seizure control outcome after anterior temporal lobectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Neurosurgery, Veterans General Hospital, Taipei, Taiwan R.O.C.
authors.forename: Y H
authors.initials: YH
authors.lastname: Shih
authors.forename: C H
authors.initials: CH
authors.lastname: Yiu
authors.forename: M S
authors.initials: MS
authors.lastname: Su
authors.forename: D J
authors.initials: DJ
authors.lastname: Yen
authors.forename: D M
authors.initials: DM
authors.lastname: Ho
authors.forename: R S
authors.initials: RS
authors.lastname: Liu
authors.forename: C C
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D017029:Epilepsy, Complex Partial / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D013702:Temporal Lobe / Q000601:surgery*