Abstracts

Rationale: The objective of economic mesial temporal lobe epilepsy (MTLE) surgery is to eliminate the epileptogenic ictal zone defined as the amount of cerebral tissue necessary and sufficient to be resected for seizure control at low-cost surgery equivalent to ordinary foreign-tissue lesions. Methods: A group of 93 unilateral mesial temporal lobe epilepsy (MTLE) seizure-free patients with more than 5 years follow-up operated between 1987 and January 2000 have been retrospectively selected. The presurgical protocol included long term scalp Video-EEG (1-2 weeks) 10-20 recording with frontal and temporal complementary electrodes, qualitative and quantitative MRI images, memory testing and normal psychiatric evaluation. Selective amygdalo-hippocampectomy through neuronavigation was performed. Results: All cases showed 100% concordance between interictal, ictal scalp Video-EEG, MRI hippocampal sclerosis and adequate lack of memory. Sleep EEG interictal spiking agreed with ictal localization in 100% of cases. Memory testing indicated enough contralateral memory reserve without memory deficit after surgery as well. Conclusions: Economic low-cost mesial temporal lobe epilepsy surgery may have done with 100% concordance between not expensive sleep EEG interictal spiking, MRI hippocampal sclerosis, and adequate lack of memory.