Abstracts

Rationale: Newly developed ictal semiology after epilepsy surgery might be a possible cause of intractability. Methods: Prognosis after temporal lobectomy in 64 patients with medial temporal lobe epilepsy with hippocampal sclerosis was analyzed with mean follow-up duration of 61.8 months (36-206) and mean analysis time point was 7.8 years (6- 14) after the surgery.Results: Twenty seven patients, who had not achieved complete seizure control, experienced recurrence of the habitual seizure. Ten (37 %) among the 27 patients without complete remission showed newly developed, nocturnal 2 generalized tonic clonic (GTC) seizure which was not documented before the surgery in this group and in contrast, habitual seizures had been completely controlled after the temporal lobectomy. Statistical analysis about the profiles of seizure characteristic including ictal EEG pattern between two groups did not show any significant differences except for the female preponderance in newly developed nocturnal GTC group.Conclusions: These results suggested new ictal semiology might be related to the temporal lobectomy itself rather than unfaithful history taking before the surgery. Newly developed ictal semiology might be related to surgical failure and regarded as one cause of intractability in epilepsy surgery. It seemes to be released from undiscovered, potential epileptic foci after temporal lobectomy. For the conclusion, we need more data and discussion.