Abstracts

RATIONALE: Intractable temporal lobe epilepsy (TLE) is the most common presentation for epilepsy surgery. Published studies of patients who underwent anterior temporal lobectomy (ATL), showed seizure free rate of 60-70 % at 6 month and 52-58% at 2 years.
METHODS: A retrospective study of the seizure outcome in patients who underwent temporal lobectomy at the Cleveland Clinic between 1991-2001 was performed. The records of 427 adult patients (age more than 18 years) were reviewed. Only patients with documented seizure outcome ( at least 6 months of post operative follow up ) and in whom pathological diagnosis was available were included in the study. Average age at the time of surgery was 32 years (range 18-65 years). There were 193 females and 234 males.
Engel[ssquote]s classification for seizure outcome was used for outcome assessment
RESULTS: Follow up was available in 381 patients. Overall 273/381 (71 %) patients were seizure free ( Engel[ssquote]s class I ) at the last follow up ([gt] 6 months) and 39 % continued to have seizures ( Engel[ssquote]s class II-11 %, III-6 %, IV-12 %). The seizure free outcome relative to the underlying pathology was as follows: HS (74 %), tumors (77 %), cortical dysplasia (69 %), non-specific changes/ other diagnosis (69 %).
CONCLUSIONS: Our results in a large group of adult TLE patients operated at the same institute after 1991 show an improvement in seizure outcome of 71 %. A significant seizure control (Engel[ssquote]s class I and II) was achieved in 82 % of patients. In addition, seizure outcome was not related to the pathological diagnosis. Studies to identify the predictors of both success and failure in seizure control after ATL are underway.
At the end of this activity, the participitants should be able to discuss the outcome of temporal lobectomy performed at our institute between 1991-2001.