J Korean Neurosurg Soc.  2001 Jan;30(1):26-32.

Surgical Outcome of Intractable Seizure with Space-Occupying Lesion in Temporal Lobe

• Park JB
• Lee WS
• Lee JK
• Jeon SR
• Kim JH
• Roh SW
• Ra YS
• Kim CJ
• Kwun BD
• Kang JK
• Kwon Y
• Rhim SC
• Lee SA
• Ko TS

Abstract

OBJECTIVE
The increasing use of sensitive neuroimaging techniques has demonstrated that significant percentage of patients with intractable complex partial seizures have brain masses, especially in temporal lobe. The optimal surgical solution for these patients is still open to debate. The purpose of our investigation is to evaluate the surgical outcome of patient with lesion-related temporal lobe epilepsy with respect to the types of surgery and the location of lesion.
PATIENTS AND METHODS
From DEC. 1993 to Dec. 1997, 35 patients with intractable epilepsy and space occupying temporal lobe lesion identified in preoperative MRI were included in this study. The types of surgery were lesionectomy, anterior temporal lobectomy with or without hippocampectomy. The location of lesion was divided as anteromedial group and lateral cortical group. The postoperative seizure outcomes according to the type of surgery and location of the lesion were compared.
RESULTS
Twenty-six of 34 patients(76.5%) were seizure-free after surgery. The Engel's class was favorable after anterior temporal lobectomy with or without hippocampectomy(p=.044).
CONCLUSION
It is favorable to perform anterior temporal lobectomy for the treatment of intractable epilepsy with space-occipying lesion in temporal lobe. The resection of the hippocampus can be individualized.

Keyword

Temporal lobe epilepsy; Anterior temporal lobectomy; Lesionectomy

MeSH Terms

Anterior Temporal Lobectomy
Brain
Epilepsy
Epilepsy, Temporal Lobe
Hippocampus
Humans
Magnetic Resonance Imaging
Neuroimaging
Seizures*
Temporal Lobe*