Surgical treatment of independent bitemporal lobe epilepsy defined by invasive recordings

W Boling
May 2009
Journal of Neurology, Neurosurgery & Psychiatry;May2009, Vol. 80 Issue 5, p533
Academic Journal
OBJECTIVES: Bitemporal lobe epilepsy is commonly encountered in the evaluation of pharmacoresistant epilepsy. Yet the role of surgery in the management of these patients is unclear. This study evaluates the impact of surgery on seizure tendency and quality of life, as well as prognostic indicators in individuals with proven ictal onset bitemporal lobe epilepsy. METHODS: The study population comprised all patients who underwent temporal lobe surgery over a 10 year period and had ictal onset bitemporal lobe epilepsy identified with intracranial electrode monitoring. Patients with extratemporal seizure generators were excluded. Subjects were divided into a favourable or less favourable group based on the results of surgery on seizure tendency. RESULTS: 11 subjects were studied with a mean 5.9 years of post-surgical follow-up. Six subjects constituted the favourable outcome group. Four had a less favourable outcome and continued to have frequent seizures after surgery; however, three with less favourable seizure reduction subjectively reported improvement in quality of life after surgery as a result of reduced seizure frequency and severity, and reduced medications. No single preoperative factor was significantly different between the groups, including ictal EEG laterality, epilepsy duration, age at surgery, age at seizure onset and mesial temporal atrophy. CONCLUSIONS: Surgical resection is an important treatment option for medically intractable bitemporal epilepsy. The proportion of seizures arising from one temporal lobe is not reliable as a single indicator to prognosticate the results of surgery on seizure tendency. In addition, individuals who achieved only palliation by reducing seizure frequency experienced improvement in quality of life.


Related Articles

  • What to do with Intractable Seizures. H. T. // School Health Alert;May2012, Vol. 27 Issue 9, p4 

    The article presents information on a study related to the investigation of surgical therapy for the treatment of temporal lobe epilepsy which is a major cause of drug-resistant seizures. It is mentioned that out of the 38 participants of the clinical trial, those who received surgery had more...

  • Scale Invariance Properties of Intracerebral EEG Improve Seizure Prediction in Mesial Temporal Lobe Epilepsy. Gadhoumi, Kais; Gotman, Jean; Lina, Jean Marc // PLoS ONE;Apr2015, Vol. 10 Issue 4, p1 

    Although treatment for epilepsy is available and effective for nearly 70 percent of patients, many remain in need of new therapeutic approaches. Predicting the impending seizures in these patients could significantly enhance their quality of life if the prediction performance is clinically...

  • Neuronavigation and epilepsy surgery. Glaser, Martin B.; Werhahn, Konrad J.; Grunert, Peter; Sommer, Clemens; Müller-Forell, Wibke; Oertel, Joachim // Health (1949-4998);Jul2010, Vol. 2 Issue 7, p753 

    Resective epilepsy surgery is an elective therapy indicated in focal epilepsy patients who are resistant to pharmacotherapy. Every effort should be undertaken to perform the procedures as safe and less traumatic as possible. Neuronavigation could represent a suitable tool to reduce surgical...

  • Changes in Social Functioning After Surgical Treatment for Temporal Lobe Epilepsy. Savard, Robert J.; Walker, Evelyn // Social Work;Jan65, Vol. 10 Issue 1, p87 

    The article presents a study on changes in social functioning after surgical treatment for temporal lobe epilepsy. Persons suffering from temporal lobe epilepsy experience numerous, and sometimes severe, difficulties in social functioning. They encounter social rejection of varying degrees and...

  • Reoperation after selective amygdalohippocampectomy: an MRI analysis of the extent of temporomesial resection in ten cases. Zachenhofer, Iris; Novak, Klaus; Baumgartner, Christoph; Prayer, Daniela; Czech, Thomas // Acta Neurochirurgica;Feb2011, Vol. 153 Issue 2, p239 

    Background: Selective amygdalohippocampectomy (SAHE) yields 60-80% of patients with medically refractory mesial temporal lobe epilepsy seizure-free and seems to be equally effective compared to the more extended temporal lobe resections. The resection of the entire entorhinal cortex (EC) is of...

  • Surgery for temporal lobe epilepsy. Elwes, Robert D C // BMJ: British Medical Journal (International Edition);3/2/2002, Vol. 324 Issue 7336, p496 

    Editorial. Discusses the use of surgery for temporal lobe epilepsy (TLE), which is considered effective. Association of surgery with sustained and major improvements in quality of life; Mesial temporal sclerosis with scarring of the hippocampus, which is the commonest pathology in chronic TLE;...

  • Post-Stroke Epilepsy in Young Adults: A Long-Term Follow-Up Study. Arntz, Renate; Rutten-Jacobs, Loes; Maaijwee, Noortje; Schoonderwaldt, Hennie; Dorresteijn, Lucille; van Dijk, Ewoud; de Leeuw, Frank-Erik // PLoS ONE;Feb2013, Vol. 8 Issue 2, p1 

    Background: Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with...

  • HIRUR�KO LECENJE TEMPORALNE EPILEPSIJE. Kelemen, Ana; Bo�ic, Ksenija; Halasz, Peter // Medicinski Pregled / Medical Review;2008, Vol. 61 Issue 1/2, p27 

    Introduction The surgical treatment of epilepsy is a therapeutic procedure aimed at removal of the brain tissue responsible for seizures. Neurological examinations are performed to delineate the epileptic zone, which is then removed, without causing a functional deficit. In order to fulfill...

  • Radiosurgery for Mesial Temporal Lobe Epilepsy -- A Possible Alternative to Temporal Lobectomy. Kandula, Padmaja // Neurology Alert;Jun2009, Vol. 27 Issue 10, p76 

    MESIAL TEMPORAL LOBE EPILEPSY WITH MESIAL TEMporal sclerosis is the most surgically remediable epilepsy syndrome, with reported success rates of nearly 70%. However, in recent years, novel approaches to reduce the invasiveness--and perhaps the cognitive deficits--of open surgery have become...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics