Surgery for temporal lobe epilepsy in Indonesia: Seizure elimination on the first 38 cases
Zainal Muttaqin
Abstract
Zainal Muttaqin
Abstract
intractable, and surgery gives benefit in about 50 % of those intractable cases. Complex partial epilepsy with epileptogenic focus located in the temporal lobe gains most from surgery with seizure elimination rate reaches more than 60%, and another 30 % benefits from the operation.1 In order to evaluate the results of epilepsy surgery in Indonesia, we would like to report our preliminary result of operations performed on intractable temporal lobe epilepsy during the period of July 1999 to June 2003. The length of follow-up was at least 12 months. Methods: There were 38 patients, consisted of 24 males and 14 females, aged between 3-38 year-old. Magnetic Resonance (MR) imaging diagnoses were hippocampal sclerosis and/or atrophy in 32 patients, temporal lobe tumor in 3 patients (disembryoblastic neuroepithelial tumor or D-NET, pleomorphic xantho-astrocytoma of the hippocampus, and benign cyst one patient each); hemispheric hemiatrophy, calcified lesion, and normal MRI one patient each. One patient with hippocampal sclerosis had also ipsilateral temporal lobe infarction since childhood. The seizure attacks were between 1-2 times to 6-10 times monthly despite administration of 3-4 antiepileptic drugs (AEDs) in combination. Preoperatively, all patients had at least one 0.5 Tesla MRI evaluation, and repeated interictal scalp EEG. Intracranial subdural grid EEG was performed in one patient with doubtful results
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intractable, and surgery gives benefit in about 50 % of those intractable cases. Complex partial epilepsy with epileptogenic focus located in the temporal lobe gains most from surgery with seizure elimination rate reaches more than 60%, and another 30 % benefits from the operation.1 In order to evaluate the results of epilepsy surgery in Indonesia, we would like to report our preliminary result of operations performed on intractable temporal lobe epilepsy during the period of July 1999 to June 2003. The length of follow-up was at least 12 months. Methods: There were 38 patients, consisted of 24 males and 14 females, aged between 3-38 year-old. Magnetic Resonance (MR) imaging diagnoses were hippocampal sclerosis and/or atrophy in 32 patients, temporal lobe tumor in 3 patients (disembryoblastic neuroepithelial tumor or D-NET, pleomorphic xantho-astrocytoma of the hippocampus, and benign cyst one patient each); hemispheric hemiatrophy, calcified lesion, and normal MRI one patient each. One patient with hippocampal sclerosis had also ipsilateral temporal lobe infarction since childhood. The seizure attacks were between 1-2 times to 6-10 times monthly despite administration of 3-4 antiepileptic drugs (AEDs) in combination. Preoperatively, all patients had at least one 0.5 Tesla MRI evaluation, and repeated interictal scalp EEG. Intracranial subdural grid EEG was performed in one patient with doubtful results
Key concepts: Temporal lobe, Epilepsy, Hippocampal sclerosis, Ictal, Medicine, Magnetic resonance imaging, Surgery, Epilepsy surgery