title: Outcome after temporal lobectomy in patients with medically-refractory mesial temporal epilepsy in Iran.
abstract: BACKGROUND
  Epilepsy surgery has been proved to be feasible and cost-effective in developing countries. In the current paper, we discussed the outcome of patients with mesial temporal lobe epilepsy (MTLE) and medically-refractory seizures who had surgery at our center in Shiraz, Iran.
  
  
  METHODS
  Patients aged 18 years and older with refractory MTLE and mesial temporal sclerosis operated at Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran from May 2009 through December 2011 were enrolled. Presurgical evaluation included clinical history, neurological examination, 2-hour video-EEG recording, and 1.5-T MRI. All patients were submitted to standard temporal lobectomy at the side determined by MRI and video-EEG.
  
  
  RESULTS
  Twenty-two patients (12 women and 10 men) underwent surgery between May 2009 and December 2011. All patients were followed postoperatively for at least 12 months (mean=24.8±7.7 months; minimum=12 months; maximum=36 months). At the last follow-up visit, 18 patients (81.8%) had a good outcome (15 patients [68.2%] had Engel class 1 and three others had Engel class 2). The total cost of presurgical evaluation and epilepsy surgery at our center was less than $500.
  
  
  CONCLUSIONS
  Resources are limited for the vast majority of medically-refractory patients with epilepsy who live in the developing countries. However, it is feasible to select good surgical candidates for anterior temporal lobectomy relying on the clinical history and examination, MRI and interictal EEG. Broader application of epilepsy surgery should be encouraged in countries with limited financial resources.
authors: Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran - aliasadipooya@yahoo.com.|Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran - aliasadipooya@yahoo.com.|Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA - aliasadipooya@yahoo.com.
authors: Ali A
authors: AA
authors: Asadi-Pooya
authors: Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Seyed M
authors: SM
authors: Rakei
authors: Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Ahmad
authors: A
authors: Kamgarpour
authors: Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.|Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mousa
authors: M
authors: Taghipour
authors: Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.|Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Nahid
authors: N
authors: Ashjazadeh
authors: Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.|Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Ali
authors: A
authors: Razmkon
authors: Department of Radiology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Zahra
authors: Z
authors: Zare
authors: Medical Imaging Research Center, Department of Radiology, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mohammad H
authors: MH
authors: Bagheri
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries / Q000191:economics; D000069279:Drug Resistant Epilepsy / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000191:economics / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D008297:Male; D019635:Neurosurgical Procedures / Q000191:economics / Q000379:methods*; D017063:Outcome Assessment, Health Care; D014402:Tuberous Sclerosis / Q000191:economics / Q000601:surgery; D055815:Young Adult