Surgical treatment of temporal lobe epilepsy with non - lesional MRI

Objective To determine the long- term efficacy of anterior temporal lobectomy for medically refractory temporal lobe epilepsy in patients with non- lesional magnetic resonance imaging (MRI).Methods The clinical data of 32 patients with non - lesional modem seizure protocol MRI who underwent anterior temporal lobectomy for treatment of medically refractory epilepsy from April 2004 to December 2009 at BeiJing SanBo Epilepsy Center were collected retrospectively.The preoperative examinations,surgical methods,results of pathological test and surgical efficacy of these patients were analyzed.Postoperative seizure freedom was determined by ANOVA analysis.Results Engel class Ⅰ outcomes (free of disabling seizures) were observed in 66％ (21 of 32) patients,class Ⅱ in 12％ (4 of 32) and Engel class Ⅲ ～ Ⅳ in 22％ (7 of 32).Better efficacy was observed in patients whose epileptiform discharges in scalp Vedio -EEG (vedio electroencephalogram) were characterized within unilateral temporal lobe,and 86％ of these patients had Engel class Ⅰ outcomes.Conclusions In carefully selected patients with temporal lobe epilepsy and non -lesional MRI,anterior temporal lobectomy could often render patients free of disabling seizures with the detection of concordant abnormalities,especially for patients with epileptiform discharge confined within unilateral temporal lobe. Key words: Temporal lobe epilepsy ;  Anterior temporal lobectomy;  Complex partial seizures; Nonlesional MRI