title: Outcome of surgical treatment of hippocampal sclerosis from relatively new epilepsy surgery center.
abstract: BACKGROUND
  Surgery is apparently superior to prolonged medical therapy in therapy of efficacy and safety for mesial temporal lobe epilepsies. We ‑ as a new center ‑ presented outcome results and possible outcome predictors of 50 consecutive patients with hippocampal sclerosis underwent resective epilepsy surgery.
  
  
  METHODS
  Between 2006 and 2011, fifty patients with intractable mesial temporal lobe epilepsy due to hippocampal sclerosis underwent anterior temporal lobectomy and they were followed-up at least 1 year postoperatively. Detailed neuropsychological tests, video-electroencephalography monitoring and magnetic resonance imaging with epilepsy protocol were obtained for all patients. Standard anteromedial temporal lobectomy was performed. Modified Engel and ILAE classifications were used for seizure outcome. All morbidities were recorded. Demographic variables, diagnostic tests and early postoperative outcome were analyzed for possible predictors of the ultimate seizure outcome.
  
  
  RESULTS
  Fifty patients were evaluated. The mean follow-up duration was 47,1 month (range, 12-75 months). The favorable outcome at 1 year was 90% and 82% according to Engel and ILAE classifications respectively. These rates were almost same at the end of follow-up period (92% and 82% respectively). The completely seizure free rate at one year was 80% and decreased to 68% at the end of the follow-up. There was no mortality. Morbidity rate was 10% and none of them was permanent. Triple concordance of the noninvasive tests (neuropsychological tests, video- electroencephalography monitoring and magnetic resonance imaging) and favorable seizure outcome at the first year were predictors of the ultimate seizure outcome (P=0.01 and P=0.04 respectively).
  
  
  CONCLUSIONS
  Our findings demonstrated that anteromedial temporal lobectomy is a safe and effective treatment method in well-chosen patients with hippocampal sclerosis. This surgical procedure can be performed with a low rate of morbidity even in relatively new epilepsy surgery center.
authors.affiliation: Department of Neurosurgery, Bakirköy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Bakirköy, Istanbul, Turkey - bekirtugcu@superonline.com.
authors.forename: Bekir
authors.initials: B
authors.lastname: Tugcu
authors.forename: Abuzer
authors.initials: A
authors.lastname: Gungor
authors.forename: Aykut
authors.initials: A
authors.lastname: Akpinar
authors.forename: Demet
authors.initials: D
authors.lastname: Kinay
authors.forename: Demet Y
authors.initials: DY
authors.lastname: Kuscu
authors.forename: Günay
authors.initials: G
authors.lastname: Gül
authors.forename: Nalan
authors.initials: N
authors.lastname: Kayrak
authors.forename: Cahit
authors.initials: C
authors.lastname: Keskinkilic
authors.forename: Hidayet
authors.initials: H
authors.lastname: Akdemir
authors.forename: Erhan
authors.initials: E
authors.lastname: Emel
mesh_terms: D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000379:methods; D002648:Child; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012598:Sclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult