title: Long-term surgical outcomes in patients with drug-resistant temporal lobe epilepsy and no histological abnormalities.
abstract: BACKGROUND
  Reports on surgical outcomes in patients with drug-resistant temporal lobe epilepsy without histological abnormalities are scarce.
  
  
  METHODS
  Retrospective review of data from patients with drug-resistant temporal lobe epilepsy and no histopathological alterations who underwent anterior mesial temporal lobectomy. We analysed the following variables: age, sex, age at seizure onset, age at surgery, time elapsed between diagnosis and the date of the surgery, follow-up time, and classification according to the Engel rating scale.
  
  
  RESULTS
  From a database of 256 temporal lobectomies, 21 were identified as meeting the inclusion criteria. The average age upon diagnosis of epilepsy was 8.3 years and average age at time of surgery was 28.6 years. The mean time elapsed between diagnosis and surgery was 20.2 years. After a mean follow-up of 6.5 years, 90.5% of the patients showed favourable outcomes (classes i and ii) and 42.9% were seizure-free (class IA). Comparative analysis of the variables revealed that average age at seizure onset was the only statistically significant difference between groups, with age at onset being lower in patients with favourable outcomes.
  
  
  CONCLUSIONS
  Although long-term surgical outcomes were favourable for a large majority of patients, the percentage of seizure-free patients is lower than in patients with lesional epilepsy and comparable to that previously reported in the literature.
authors.affiliation: Departamento de Investigación, Centro Latinoamericano de Investigación en Epilepsia (CLIE), Cartagena de Indias, Colombia. Electronic address: benedetti.jc@gmail.com.
authors.forename: J C
authors.initials: JC
authors.lastname: Benedetti-Isaac
authors.forename: M
authors.initials: M
authors.lastname: Torres-Zambrano
authors.forename: J
authors.initials: J
authors.lastname: Fandiño-Franky
authors.forename: J
authors.initials: J
authors.lastname: Dussán-Ordóñez
authors.forename: A
authors.initials: A
authors.lastname: Herrera-Trujillo
authors.forename: R
authors.initials: R
authors.lastname: Guerra-Olivares
authors.forename: G
authors.initials: G
authors.lastname: Alcalá-Cerra
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects / Q000379:methods*; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Cirugía de epilepsia; Drug-resistant epilepsy; Epilepsia del lóbulo temporal; Epilepsia médicamente refractaria; Epilepsy surgery; Lobectomy; Lobectomía; Normal magnetic resonance imaging; Resonancia magnética normal; Temporal lobe epilepsy