[Surgical treatment of lesional temporal lobe epilepsy].
OBJECTIVE
To discuss the presurgical evaluation and surgical treatment of lesional temporal lobe epilepsy (LTLE).


METHODS
We retrospectively studied the patients whose MRI or CT showed lesions on one of the temporal lobes among patients who underwent epilepsy surgeries in our institute. All patients were divided into satisfactory and unsatisfactory group according to outcomes after operation. The characteristics of the lesions, neurophysiological features and results of pathologies were analyzed statistically.


RESULTS
Favorable surgical outcome was obtained in 24 patients, the satisfactory rate was 75%. The lesions of 17 patients were cortical malformations and the satisfactory rate of this group was 65%, which was less favorable than that of tumor group, (87%). 21 patients with their lesions located within the border of standard temporal lobectomy, had better surgical outcome than the others whose lesions were beyond the border (P<0.05). The satisfactory rate of 8 patients with lesions located within mesial structure of temporal lobe was no different compared with that of the others who had lesions outside the mesial structure (P>0.05). There were 19 patients who had consistency of the location of the lesion on MRI with the focal interictal epileptiform discharges on scalp EEG in satisfactory group, while there were only 3 patients in unsatisfactory group (P<0.05).


CONCLUSIONS
For a LTLE patient, epilepsy surgery should be the first choice to be considered. Careful presurgical studies of the lesion, including its location, pathological property and neurophysiological characteristics, were very helpful for improving the surgical outcome.
Cai
Li-xin
LX
Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, the Capital University of Medical Sciences, Beijing 100053, China.
Li
Yong-jie
YJ
Zhang
Guo-jun
GJ
Yu
Tao
T
DU
Wei
W
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011612:Psychosurgery / Q000379:methods*; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome