Surgical outcome of patients with mesial temporal lobe epilepsy related to hippocampal sclerosis.
Seizure outcome in mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) that was evaluated according to a noninvasive protocol was assessed in 165 patients and reported using both Engel's and ILAE classifications. The mean postoperative follow-up was 5.0 +/- 2.7 years. At the end of first year, 77.1% of patients were in Engel-I, and 52.7% were in ILAE-I. Antiepileptic drugs (AEDs) were discontinued in 41 patients (42.7%), all remained seizure-free for >or= 2 years that could be accepted as "cure." Thirty-six patients had recurrences, 19 had running-down phenomena. Anterior temporal lobectomy (ATL) was performed in 27 patients with a better outcome when compared to patients operated by selective anterior hippocampectomy. Clinical risk factors for better and worse outcome, which show some similarity in different reports, seem to veil the main reason, which is the accurate delineation of epileptogenic zone considering the presence of different subgroups and underlying developmental pathologies.
Ozkara
Ciğdem
C
Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. cigdemoz@istanbul.edu.tr
Uzan
Mustafa
M
Benbir
Gülçin
G
Yeni
Naz
N
Oz
Büge
B
Hanoğlu
Lütfü
L
Karaağac
Naci
N
Ozyurt
Emin
E
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D038481:Anterior Temporal Lobectomy; D002648:Child; D018572:Disease-Free Survival; D004833:Epilepsy, Temporal Lobe / Q000145:classification / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012598:Sclerosis / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome