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Temporal Neocorticectomy in Management of Intractable Epilepsy: Long‐Term Outcome and Predictive Factors
Author(s) -
Keogan M.,
McMackin D.,
Peng S.,
Phillips J.,
Burke T.,
Murphy S.,
Farrell M.,
Staunton H.
Publication year - 1992
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1992.tb02193.x
Subject(s) - epilepsy , temporal lobe , ictal , intractable epilepsy , epilepsy surgery , population , psychology , anterior temporal lobectomy , medicine , surgery , neuroscience , environmental health
Summary: We report the results of a long‐term follow‐up study of 50 patients who underwent removal of temporal neocortex with preservation of deeper limbic structures as surgical therapy for intractable temporal lobe epilepsy. The follow‐up period ranged from 3 to 15 years. Preoperative EEG investigations were based on interictal discharges alone. Three factors were predictive of a good outcome: (a) A clear unilateral anterior‐midtemporal focus (p < 0.01), (b) stereotypical onset of temporal lobe seizure (p < 0.005), and (c) greater volume of tissue removed at operation (p < 0.05). Overall results showed that 62% of patients experienced an outcome of “cure” or “almost cure,” as classified according to a modified version of Crandall's criteria (Crandall's I and II). Those who experienced a significant reduction in seizures but who continued to have intractable epilepsy (Crandall's III) were not considered to have had a good result. Overall outcome compares favorably with other that of centers using different surgical approaches and indicates that neocorticectomy is a suitable procedure in a highly selected population even when limited resources are available.