title: Predictors of surgical outcome in medically-resistant temporal lobe epilepsy with bilateral features on pre-operative evaluation.
abstract: OBJECTIVE
  This study identifies potential prognostic factors for favorable anterior mesial temporal lobe (AMTL) resection outcomes in patients with medically refractory temporal lobe epilepsy (TLE) with bilateral features on pre-operative examination.
  
  
  METHODS
  Thirty-one patients demonstrated bilateral features defined as: bilateral independent temporal or bitemporal ictal onsets on surface or intracranial EEG, or bitemporal interictal epileptiform abnormalities on surface EEG with bilateral radiographic mesial temporal sclerosis. Surgical outcomes were classified according to reduction in seizure frequency: I (100% reduction), II (≥75% reduction), III (50-74% reduction), IV (<50% reduction).
  
  
  RESULTS
  Of 31 patients, 14 (45%) improved to class I and 9 (29%) had a class II outcome at an average of 4 years after surgery. Eight (26%) patients did not exhibit good surgical outcome (class III, class IV). We found that neuropsychological and Wada memory scores were significantly correlated (p<0.05) with surgical outcome, and logistic regression found neuropsychological evaluation significantly predicted better surgical outcome (p<0.05).
  
  
  CONCLUSIONS
  When bilateral features are present on pre-operative evaluation, neuropsychological and Wada test results can provide unique data to better identify those patients more likely to achieve substantial seizure reduction.
authors.affiliation: Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA. Electronic address: hwaseem@health.usf.edu.
authors.forename: Hena
authors.initials: H
authors.lastname: Waseem
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, 3515 East Fletcher Avenue, Tampa, FL 33613, USA. Electronic address: keichsta@health.usf.edu.
authors.forename: Katie E
authors.initials: KE
authors.lastname: Osborn
authors.affiliation: Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA; Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, 3515 East Fletcher Avenue, Tampa, FL 33613, USA; Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA. Electronic address: mschoenb@health.usf.edu.
authors.forename: Mike R
authors.initials: MR
authors.lastname: Schoenberg
authors.affiliation: Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA. Electronic address: vkelley@tgh.org.
authors.forename: Valerie
authors.initials: V
authors.lastname: Kelley
authors.affiliation: Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA. Electronic address: abozorg@health.usf.edu.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Bozorg
authors.affiliation: Department of Neurology, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 6th Floor, Tampa, FL 33606, USA. Electronic address: sbenbadi@health.usf.edu.
authors.forename: Selim R
authors.initials: SR
authors.lastname: Benbadis
authors.affiliation: Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, USF Health, 7th Floor, Tampa, FL 33606, USA. Electronic address: fvale@health.usf.edu.
authors.forename: Fernando L
authors.initials: FL
authors.lastname: Vale
mesh_terms: D000328:Adult; D000069279:Drug Resistant Epilepsy / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D055815:Young Adult
keywords: Bitemporal seizures; Epilepsy surgery; Intractable epilepsy; Neuropsychology; Seizure disorder; Temporal lobe epilepsy