Seizure Outcome of Patients with Bilateral Temporal Lobe Sclerosis: A Controlled Study in a Tertiary Epilepsy Center

1 Division of Neurosurgery, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil. 2 Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil. 3 Department of Surgery. Division of Neurosurgery. Santa Casa de São Paulo School of Medical Science (FCMSCSP). São Paulo, Brazil. 4 Department of Psychiatry and Medical Psychology, Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil. 5 Division of Neurology, Hospital de Base, Department of Neurologic Sciences, Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil. ABSTRACT Introduction: Surgery for refractory temporal lobe epilepsy (TLE) has been a well-defined procedure to provide seizure control in the recent years. Objective: The aim of the present study is to evaluate seizure outcome of patients with TLE and bilateral mesial temporal sclerosis (bMTS) after cortico-amygdalohippocampectomy compared with those presenting unilateral (uMTS) lesions. Method: A case-controlled study was conducted in patients with TLE and bMTS or uMTS treated in the epilepsy clinic of the Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), a Brazilian tertiary referral epilepsy center, from January 2000 to March 2012. Patients with neuroradiological evidence and/or neuropathological confirmation of other diseases than MTS, as well as additional potential epileptogenic MRI-lesions, were excluded from the study. Results: During this period, 533 patients underwent multidisciplinary investigation of epilepsy and 229 (43%) fulfilled criteria to be included in the present study, 60 (26.2%) with bMTS and 169 (73,8%) with uMTS. Thirty-seven (61.6%) were classified as Engel I in bMTS group, while 107 (63.3%), were classified as Engel in uMTS group. There was no mortality in both groups. Conclusion: The present data highlight that a favorable seizure outcome can also be obtained in patients with bMTS after adequate pre-surgical evaluation. Key-words: Mesial temporal sclerosis; Cortico-amygdalohippocampectomy; Surgical outcome