Mesial temporal lobe surgery and other lobar resections

Temporal lobe and other lobar surgeries for epilepsy have a long history, are well established and have shown better seizure outcome and decreased complication rates over time and with more experience in epilepsy centres. This chapter discusses the work-up, efficacy and potential complications of temporal and other lobar resections for the control of epileptic seizures. Epilepsy surgery outcomes vary according to the location and pathology of the seizures. Medial temporal lobectomy has better reported postoperative seizure control rates than the other neocortical surgeries. Medial temporal resection represents surgery that is fundamentally different from neocortical epilepsy surgery in that it encompasses a standardized approach based on the understanding of a well-defined syndrome and pathophysiology; therefore it may have a more favourable prognosis. The discussion of seizure outcomes will be organized based on location, with medial temporal lobectomy being discussed separately from the neocortical resection outcomes.