gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Article

Send article

Surgical treatment of drug resistant temporal lobe epilepsy due to hippocampal sclerosis: results in a consecutive series of 139 patients with long-term follow-up

Meeting Abstract

Search Medline for

  • Tommaso Vangelista - Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy
  • R. Morace - Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy
  • S. Paolini - Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, “Sapienza” University of Rome, Italy
  • E. Gianfrancesco - Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy
  • P. P. Quarato - Epilepsy Surgery Unit, Department of Neuroscience, IRCCS Neuromed, Pozzilli (IS), Italy
  • G. Di Gennaro - Epilepsy Surgery Unit, Department of Neuroscience, IRCCS Neuromed, Pozzilli (IS), Italy
  • A. Mascia - Epilepsy Surgery Unit, Department of Neuroscience, IRCCS Neuromed, Pozzilli (IS), Italy
  • A. D'Aniello - Epilepsy Surgery Unit, Department of Neuroscience, IRCCS Neuromed, Pozzilli (IS), Italy
  • L. Grammaldo - Epilepsy Surgery Unit, Department of Neuroscience, IRCCS Neuromed, Pozzilli (IS), Italy
  • V. Esposito - Neurosurgery, IRCCS Neuromed, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, “Sapienza” University of Rome, Italy

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.12.08

doi: 10.3205/15dgnc330, urn:nbn:de:0183-15dgnc3306

Published: June 2, 2015

© 2015 Vangelista et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: We reviewed a consecutive series of 139 patients operated upon in our Institute for drug resistant temporal lobe epilepsy (TLE) due to hippocampal sclerosis, between 1999 and 2008: all patients were followed up for at least 5 years (mean duration of follow-up 9.1 years, range 5-15).

Patients' age ranged from 11 to 62 years with a mean age of 36 years. There were 57 males and 82 males. Age at onset of seizures ranged from 1 to 48 years with a mean of 13 years. Epilepsy duration at the time of surgery ranged from 2 to 49 years with a mean of 23 years. All patients were selected for surgery after a non-invasive diagnostic work-up, including high-field (1,5 or 3 Tesla) MRI, long-term video-EEG monitoring, neuropsychological and psychiatric assessment.

Anterior temporal lobectomy was carried out by the last author (V.E.) in all cases. Post-operative complications consisted of 1 case of hemiparesis and 2 cases of transient dysphasia. Up to the last follow-up visit, 99 patients were in Engel class 1A, 7 patients were in class 1B, 9 were in class 1C, 9 were in class 1D, 3 were in class 2A, 4 were in class 2B, 7 were class 3A and 1 in Class 4A: thus, 89% (124/139) of patients were in Engel Class 1 after a mean follow-up of 9.1 years.

In our experience, appropriate selection of patients (without the need for invasive EEG studies) and subpial surgical technique lead to optimal surgical outcomes in terms of morbidity and long-term control of seizures.

Method:

Results:

Conclusions: