Spontaneous Temporal Pole Encephalocele Presenting with Epilepsy: Report of Two Cases.
BACKGROUND
Refractory temporal lobe epilepsy due to spontaneous temporal pole encephalocele is a rare but increasingly recognized condition. Optimal surgical management is complicated by the lack of knowledge regarding both the extent of the epileptogenic area and the need for repair of the encephalocele.


METHODS
We report two cases that add significant information to these issues. In Case 1, with a 5-year history of refractory seizures, implantation of diagnostic subdural electrodes into the anterior temporal base happened to abolish the seizures completely. No structural changes were evident on postoperative magnetic resonance imaging. In Case 2, with a large encephalocele and a 5-year history of refractory seizures, surgical disconnection of the temporal pole successfully abolished seizures without any need for encephalocele repair.


CONCLUSIONS
These two cases support the view that the epileptogenic area is confined to within the temporal pole for spontaneous temporal pole encephalocele. Temporopolar disconnection represents one surgical option for this entity that achieves seizure cessation without requiring extra repair procedures.
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan.
Seijiro
S
Shimada
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan. Electronic address: nkunii-tky@umin.ac.jp.
Naoto
N
Kunii
Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan.
Kensuke
K
Kawai
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan.
Kenichi
K
Usami
Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan.
Takeshi
T
Matsuo
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan.
Takeshi
T
Uno
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan.
Tomoyuki
T
Koizumi
Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan.
Nobuhito
N
Saito
D000328:Adult; D000069279:Drug Resistant Epilepsy / Q000209:etiology* / Q000601:surgery*; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004677:Encephalocele / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D013355:Subdural Space; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
Temporal lobe epilepsy; Temporal pole encephalocele; Temporopolar disconnection