A follow-up study of surgery in temporal lobe epilepsy

Abstract

One hundred consecutive temporal lobe epileptics submitted to an anterior temporal lpbectomy have been followed up for periode ranging from 2 to 10 years. Of these 53 patiente have been rendered free of seizures or almost so, 30 haye been improved, at least 50%, apd 17 show little or no improvement. After the first post- operative year a few patients appear.to migrate from one group to ,another, but from the second year onwards the ratfo of therapeutic results seems constant. The present study supports ,the.view that, whenever there is an improvement in epilepsy, there is also a corresponding improvement, in the concomitant psychiatric disorder. All. but one patient before operation showed EEG evidence of an 'epileptic focus' confined to or predominant in one temporal lobe, and after operation simultaneously with improvement in epilepsy usually the EEG record became normal, although there were exceptions. Lesions were found in the resected temporal lobe in the great majority of patients. Forty- seven were found to have mesial temporal lobe sclerosis, 24 small 'tumours' or malformations, and miscellaneous or equivocal lesions in the remainder. The results were better in the first two groups. The limitations of the present criteria for selecting patients for operation are discussed.