Abstracts

Rationale: Temporal lobe epilepsy (TLE) is the most common form of localization-related epilepsy. About 30 to 40 percent of patients with TLE are pharmacoresistant. The ITG approach for selective mesial temporal resection has been shown to have excellent seizure freedom rates with minimal cortical resection and white matter tract disruption. These data report the neuropsychological outcome of this surgical technique. Methods: Fifty-four patients were identified from a prospectively-maintained database that had Engel class I or II outcome following resection of mesial structures using a trephine ITG approach. All participants had localization-related mesial temporal lobe epilepsy (MTLE) confirmed by long-term surface video-EEG and completed pre-surgical evaluations that included video-EEG, MRI, intracarotid methohexital test and neuropsychological assessment. All patients had both pre- and post-surgical neuropsychological studies. Results: Of 54 patients, 29 had pathologically confirmed mesial temporal sclerosis (MTS). There were no significant differences between patients that had either left or right AH in regards to age (p > .05), education (p > .05) or gender (p > .05). For Left AH, No-MTS patients (n=8) there was a decline in verbal short delay (RAVLT Trial 6, p=.002), long-delay (RAVLT Trail 7, p < .001), and visual delayed memory (ROCFT Delay, p=.024) 6 months after surgery. Alternatively, for the Left AH, MTS (n=18), Right AH, No-MTS (n=15), and Right AH, MTS groups =10) there was no post-operative significant changes in neuropsychological measures of verbal and visual memory, language, attention/executive, and visuoconstructional skills (p>