This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Vicenta Salanova, MD; Omkar N. Markand, MD, FRCPC; Robert Worth, MD, PhD

Arch Neurol. 1994;51(10):1008-1013.

Abstract
Objective
To analyze the preoperative and operative factors predictive of outcome in patients undergoing surgery for temporal lobe epilepsy.

Design
From 1984 to 1992,98 patients with medically refractory temporal lobe epilepsy underwent surgery. Evaluation included the following: video electroencephalography (13 patients had intracranial recordings), head magnetic resonance imaging, interictal and ictal single photon emission computed tomography, psychometric testing, and Wada testing. Seizure-free groups and non-seizure-free groups were analyzed. Follow-up of 1 year to 8 years was available for 89 patients (mean, 3.2 years).

Setting
Indiana University Epilepsy Surgery Program, Indianapolis.

Outcome
Sixty percent (53/89) were seizure free, 16% (14/89) had rare seizures, 13% (12/89) had worthwhile improvement, and 11% (10/89) showed no improvement. Fortytwo percent of seizure-free patients had a history of febrile seizures compared with 5% of non-seizure-free patients. Ictal single photon emission computed tomography showed increased flow on the side of seizure onset in 86% of seizurefree patients compared with 62% of non-seizure-free patients. Ninety-seven percent of seizure-free patients had a pathologic diagnosis; mesial temporal structures were identified in 61%. Only 64% of non-seizure-free patients had a pathologic diagnosis, and mesial temporal structures were identified in only 36% of non-seizure-free patients.

Conclusions
Eighty-nine percent (79/89) of our patients benefited from surgery. The following factors were predictive of good outcome: a history of febrile seizures; ictal single photon emission computed tomography showing increased blood flow ipsilateral to the epileptogenic zone; a pathologic diagnosis; and the presence of mesial temporal structures in the resected tissue.

Author Affiliations
From the Department of Neurology and Division of Neurosurgery, Indiana University School of Medicine, Indianapolis.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Temporal lobectomy: long-term seizure outcome, late recurrence and risks for seizure recurrence
McIntosh et al.
Brain 2004;127:2018-2030.
ABSTRACT | FULL TEXT  

Long-term seizure outcome in patients initially seizure-free after resective epilepsy surgery
Yoon et al.
Neurology 2003;61:445-450.
ABSTRACT | FULL TEXT  

Dysplasia: A common finding in intractable pediatric temporal lobe epilepsy
Porter et al.
Neurology 2003;61:365-368.
ABSTRACT | FULL TEXT  

Long term outcome of temporal lobe epilepsy surgery: analyses of 140 consecutive patients
Jutila et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:486-494.
ABSTRACT | FULL TEXT  

A study of mortality after temporal lobe epilepsy surgery
Hennessy et al.
Neurology 1999;53:1276-1276.
ABSTRACT | FULL TEXT