Abstracts

RATIONALE: Aim of this retrospective study was to correlate etiology of temporal lobe epilepsy (TLE)with long-term seizure outcome after epilepsy surgery. METHODS: 206 patients with temporal lobe-epilepsy (age >16 yrs.) underwent epilepsy surgery between 1992 and 1997 at the epilepsy centre of Bethel. 154 answered a questionaire. We analyse the outcome in all patients divided in 4 etiology-categories: group 1 hippocampal sclerosis n=97, group 2 benign tumors (ganglioglima n=18, DNT n=4, neurozytoma n=1, epidermoid cyst n=1) n=24, group 3 cortical dysplasia n=5 and group 4 other etiologies (e.g. dual pathology, vascular malformations, oligodendroglioma, xantoastrozytoma, unspecific histological changes)n=28. RESULTS: 35.1% of the patients reported complete seizure control (group1 36.1%, group 2 33.3%, group 3 40%, Group 4 32.1%). 22.7% of the patients had only auras since surgery (group 1 24.7%, group 2 20.8%, group 3 40%, group 4 20%). 18.2% had auras and/or komplex partial seizures since surgery (group 1 14.4%, group 2 16.7%, group 3 20%, group 4 32.1%). 24% have had auras and/or complex partial (CPS) and/or generalized tonic clonic seizures (GTCS) (group 1 24.7%, group 2 29.2%, group 3 20%, group 4 21.4%). A favourable outcome with complete seizure control or auras only or single CPS/GTCS (e.g. as a consequence of drug withdrawel)had 73.4% (group 1 74,2, group 2 75%, group 3 80%, group 4 67.9%). 15.6% of the patients could be completely withdrawn from antiepileptic drug treatment (group 1 13,4%, group2 16.7%, group 3 40%, group 4 17.9%) CONCLUSIONS: There was no significant difference in seizure outcome between the 4 etiology categories. 73% of the patients with temporal lobe epilepsy had a favourable outcome after epilepsy surgery regardless of the underlying etiology. Nearly 16% do not need any anticonvulsive medical treatment for seizure control.