[Defects in the visual field in resective surgery for temporal lobe epilepsy].
BACKGROUND
Temporal lobe resection is the most used procedure in epilepsy surgery. Visual field defects after resection are frequent. AIM. We try to detect the frequency and severity of visual field defect after anterior temporal lobectomy (ATL) and to study the functional consequences.


METHODS
We studied 30 patients with refractory temporal lobe epilepsy (15 men, 12 51 years, m= 32.9), in which ATL was performed (11 right, 19 left). The neocortical and hippocampal resection was variable. Visual field was studied with computerized campimetry type Humphrey. Our survey was filled to study the campimetric consequence, seizures incidence, quality of life and surgery satisfaction.


RESULTS
Some campimetric disturb was found in 27 patients (90 %), superior or minor homonimus quadantapnosia in 18 (60 %), major one 8 and homonimus hemianopsia in one. Incongruent defects appeared in 19. The bigger neocortical and hippocampal resection was, the bigger defect, with exceptions. Only patient with a hemianopsia was conscious the deficit. 20 patients (66.6 %) were seizures free in the last year. 28 had better quality of life and 29 (96.6 %) would have chosen surgery again.


CONCLUSIONS
Visual field defects after ATL, although frequent, have little functional consequences and in quality of life. The quality of life is better when seizures stopped. After ATL patients are very glad with their decision.
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, 18013, España. neuro2000@hvn.sas.junta-andalucia.es
R
R
Hervás-Navidad
A
A
Altuzarra-Corral
J A
JA
Lucena-Martín
M
M
Castañeda-Guerrero
R
R
Vela-Yebra
J C
JC
Sánchez-A lvarez
D000293:Adolescent; D000328:Adult; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006423:Hemianopsia / Q000150:complications / Q000175:diagnosis*; D006624:Hippocampus / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014794:Visual Fields / Q000502:physiology*