[Pharmacoresistant temporal-lobe epilepsy. Exploration with foramen ovale electrodes and surgical outcomes].
OBJECTIVE
To report our experience in the surgical treatment of temporal-lobe epilepsy.


METHODS
An analysis was performed of the outcomes of 137 patients submitted to surgery between 1990 and 2001, with a follow-up of more than two years. A study was conducted of the percentages of successful detection by the different complementary tests--MRI, EEG, interictal SPECT, video-EEG with foramen ovale electrodes (FOE), neuropsychological study (NPS)--and the precision with which they reported the epileptogenic focus.


CONCLUSIONS
Successful surgical outcomes (Engel grades I-II): 73.4%. No surgical mortality occurred, although some mild, reversible morbidity was observed. Surgical outcomes were not affected by sex, age, age of onset and the length of time the patient had had the disease, or the frequency of the seizures. No association was found between seizures in the immediate post-operative period and a poorer long term control of the epilepsy. MR images were normal in 25% of patients; in these cases the surgical outcomes (Engel grades I-II at two years: 62%) were significantly poorer than in cases of tumours/cavernomas (86%); RMI studies of other types of lesions gave intermediate results (72%). With respect to the capacity of the different tests to lateralise/locate the epileptogenic focus, video-EEG-FOE proved to be the best, followed by MRI, SPECT, EEG and NPS.
Servicio de Neurocirugía, Hospital Universitario de la Princesa, Diego de León 62, 28006 Madrid, Spain. rgsola@neurorgs.com
R G
RG
Sola
V
V
Hernando-Requejo
J
J
Pastor
E
E
García-Navarrete
J
J
DeFelipe
M T
MT
Alijarde
A
A
Sánchez
L
L
Domínguez-Gadea
P
P
Martín-Plasencia
F
F
Maestú
J
J
DeFelipe-Oroquieta
S
S
Ramón-Cajal
P
P
Pulido-Rivas
D000293:Adolescent; D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004566:Electrodes; D004569:Electroencephalography / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome