The histological classification of HS was type 1 for 75.3% of … 70. Li et al found that seizure freedom was attained in 73% of patients with a lesionectomy and a medial temporal resection (resection of hippocampus, amygdala, and … In a worldwide review of epilepsy surgery carried out in 1985, 53 centres were found that had undertaken about 3500 operations for intractable epilepsy. (2018) The long-term outcomes of epilepsy surgery. Epilepsia. Recent findings . 1998; 39 (3): 319 –25. No study exclusively examined the long-term seizure remission and relapse rates among patients with pharmacoresistant temporal lobe epilepsy with medical management, but one study reported these outcomes in intractable epilepsy patients (including 50% of patients with temporal lobe epilepsy). Several reasons have been identified to explain these surgical failures. Epilepsy Behav. Brain. of long-term outcome in 325 people having anterior temporal resection, the rate of seizure freedom was 41% at 10 years. Temporal lobe epilepsy (TLE) is the most common cause of drug refractory epilepsy, especially in adults. Overall, the prognosis for people with drug-resistant medial temporal lobe epilepsy includes a higher risk for memory and mood problems, lower quality of life, and an increased risk for sudden unexpected death in epilepsy (SUDEP). N Engl J Med. Methods: Fifty-one patients who had undergone TLR (23 in the speech-dominant temporal lobe [DTL] and 28 in the nondominant temporal lobe [NDTL]) were assessed preoperatively and 2 and 10 years postoperatively. Temporal lobe resection, also called temporal lobectomy, is a surgery that can lower the number of seizures you have, make them less severe, or even stop them from happening. During the operation, the doctor removes some of the part of your brain where most seizures start. Surgery isn't the first choice for treating epilepsy symptoms. Surgery is widely accepted as an effective therapy for selected individuals with medically refractory epilepsy. Objective: To explore late effects of temporal lobe resection (TLR) for epilepsy on general cognitive level and memory. Frontal lobe epilepsy (FLE) surgery accounts for 6–30% of all epilepsy surgeries. Téllez-Zenteno JD, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: A systematic review and meta-analysis. 11 We hypothesized that the removal of the piriform cortex could improve outcome after surgery for temporal lobe epilepsy (TLE). 2014 Dec;41:91-7. doi: 10.1016/j.yebeh.2014.09.054. Ivanovic, J. et al. “Temporal plus” epilepsy (TPE) has been described as a condition in which the epileptogenic zone (EZ) extends beyond the anatomic boundaries of the temporal lobe. Objective: To assess the seizure outcomes of stereotactic laser amygdalohippocampectomy (SLAH) in consecutive patients with mesial temporal lobe epilepsy (mTLE) in a single center and identify scalp EEG and imaging factors in the presurgical evaluation that correlate with post-surgical seizure recurrence.Methods: We retrospectively reviewed the medical and EEG … Three surgical approaches were used: anterior temporal lobectomy (ATL; n = 209), transcortical selective amygdalohippocampectomy (SAH; n = 144), and transsylvian SAH (n = 36). We studied histopathology, seizure outcome, employment, school enrolment, and driver's licensing. Abstract Patients with temporal lobe epilepsy (TLE) are refractory to antiepileptic drugs in about 30% of cases. 2001; 345(5): 311–318. Wiebe S, Blume WT, Girvin JP, et al. Follow-up studies suggest that the procedure also has produced positive long-term effects that illustrate 63 percent of patients still remaining seizure-free. Introduction In this report, we aim to describe the design for the randomised controlled trial of Stereotactic electroencephalogram (EEG)-guided Radiofrequency Thermocoagulation versus Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (STARTS). Overall, 47 (90%) of 52 patients with CCMs located in the temporal lobe and CRE achieved favorable seizure outcome. Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. Dont give up on yourself, temporal lobe epilepsy is said to be the easiest surgery of all with the greatest results too. Epilepsy surgery outcomes in temporal lobe epilepsy with a normal MRI. Results: With an average follow-up of 8.7 years (range = 1.0-25.2), seizure outcome was classified as Engel I in 83.7% and Engel Ia in 57.1% of patients. Data are limited regarding diagnosis, management, and outcomes of patients with epilepsy in the setting of an encephalocele, because the literature mostly comprises case reports, case series, and retrospective studies. Sometimes temporal lobe seizures impair your ability to respond to others (partial complex or focal dyscognitive seizures). This type of temporal lobe seizure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms include: Loss of awareness of surroundings. It removes a part of the anterior temporal lobe along with the amygdala and hippocampus. One of three neurosurgeons experienced in surgery for epilepsy resected a maximum of 6.0 to 6.5 cm of the anterior lateral nondominant temporal lobe or 4.0 to 4.5 cm of the dominant temporal lobe. Temporal lobe epilepsy ( TLE) is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. TLE is the most common form of epilepsy with focal seizures. Patients who were seizure free 2 years postoperatively had a 74% (95% CI 66–81) probability of seizure freedom by 10 postoperative years. Reported success rates range from 13 to 80% (Rasmussen, 1991; Talairach et al., 1992; Fish et al., • Temporal lobe epilepsy (TLE) is the most common cause of pharmaco-resistant seizures • Most easily and effectively treated with surgery, 60-80% of patients become free of disabling seizures • More than 100,000 patients, while fewer than 2000 received surgical treatment (Engel and Shewmon, 1993) Advances in neuroimaging and neurophysiology have enabled more precise localisation of the epileptogenic zone and the eloquent … A randomized, controlled trial of surgery for temporal-lobe epilepsy. Temporal lobe surgery for intractable TLE in children has resulted in good The most recent study reported that temporal lobe epilepsy surgery “lowers but does not normalize the overall mortality associated with chronic epilepsy” 5. This favorable rate Temporal lobe resection, also called a temporal lobectomy, is a type of epilepsy surgery that involves the removal of a section of the temporal lobe. The surgery has produced successful outcomes, controlling seizures in 65 percent of temporal lobe epilepsy patients. Twenty-three healthy controls were … Long-term epilepsy surgery outcomes in patients with PET-positive, MRI-negative temporal lobe epilepsy. Increasingly, surgical treatment for temporal lobe epilepsy (TLE) is being offered to older patients and this trend will continue with improved life expectancies and reports of favourable seizure outcomes. Yang PF(1), Pei JS(2), Zhang HJ(2), Lin Q(3), Mei Z(3), Zhong … Head, Pediatric Epilepsy Cleveland Clinic Epilepsy Center LEFT TEMPORAL LOBE ASTROCYTOMA SEIZURE OUTCOME 1 YEAR AFTER EPILEPSY SURGERY IN ADULTS Temporal XTL XTL Lesion Frontal Seizure free 68% 45% 67% 23% Significantly improved 24% 35% 23% 32% Little or no improvement 8% 20% 12% 44% Appendix 2: Articles Contributing to Specific Subgroups in The Systematic Review Results Twenty-five studies were included, 12 of which had data suitable for meta-analyses. The aim of this study was to analyse the neuropsychological outcome in a consecutive series of patients with extra-temporal epilepsy. RESULTS: Number of Engel class I patients was 34 (81%) after 6 months; 32 (76%) after 1 year; 30 (71%) after … Mesial temporal lobe epilepsy (mTLE) is a classical subtype of temporal lobe epilepsy that often … A positive long-term outcome after epilepsy surgery is possible for many patients and especially those with hippocampal sclerosis or those who had anterior temporal lobe resections. Epub 2014 Oct 14. OUTCOME AFTER EPILEPSY SURGERY Prakash Kotagal, M.D. Results: 46% of patients with unilateral temporal lobe epilepsy became seizure-free, 10% had only postoperative auras, and 15% had rare seizures on follow up for (mean (SD)) 5.4 (2.6) years, range 0.25 to 10.5 years. Curative procedures are performed when tests consistently point to a specific area of the brain where the seizures begin.. Temporal lobectomy is the most common type of surgery for people with temporal lobe epilepsy. RESULTS. Temporal lobe epilepsy represents the largest group of patients with lobe epilepsy, intracranial EEG recordings may reveal unilateral seizure onset, and, particularly in the context of unilateral hippocampal sclerosis or non-lesional temporal lobe epilepsy, surgical outcomes can still be favourable17. We retrospectively analysed the data of patients operated between 1996 and 2008 for extra-temporal epilepsy. Risks of serious surgical complications have dramatically decreased over years to drop below 1% for temporal lobe resections. 50, 2053–2060 (2009). If surgery can be done to control … Cognitive outcome 10 years after temporal lobe epilepsy surgery A prospective controlled study Lena Andersson-Roswall, PhD Elisabeth Engman, PhD Hans Samuelsson, PhD Kristina Malmgren, MD, PhD ABSTRACT Objective: To explore late effects of temporal lobe resection (TLR) for epilepsy on general cogni-tive level and memory. Introduction. Five years later this had increased to over 8000 operations done in 118 centres.1 In both surveys most patients underwent resections for temporal lobe epilepsy. Eighty per cent of TLEs have onset in the hippocampus,1 and hippocampal sclerosis is a major aetiology in the adult epilepsy surgery series. HOUSTON – A machine learning interpretation of presurgical MRI studies did a better job of predicting which patients would have a successful outcome after anterior temporal lobectomy for temporal lobe epilepsy than did commonly-used clinical indicators in a prospective cohort study. Comparing seizure outcome if epilepsy surgery was performed before vs after 2, 5, 10, and 20 years of epilepsy duration, and comparing epilepsy duration <5 years to >10 years, we found significant effects favoring shorter duration with risk differences ranging from 0.15 to 0.21 and risk … Children are more likely to achieve sustained seizure freedom and withdraw AEDs after TLE surgery. Epilepsia. Article Google Scholar 10. Complications. Over time, repeated temporal lobe seizures can cause the part of the brain that's responsible for learning and memory (hippocampus) to shrink. Brain cell loss in this area may cause memory problems. resection site, and (3) subtle nonspecific MRI findings in the mesial temporal lobe concordant to the resection. good luck & good health to you babzy Re: Risk of left temporal lobe surgery Submitted by Kayne57 on Wed, 2013-04-24 15:03 The piriform cortex likely plays a facilitating and amplifying role in human epileptogenesis and may influence progression to medical intractability. Epileptogenic encephaloceles, most frequently located in the temporal lobe, are a known lesional cause of focal epilepsy. Discussion—In carefully selected patients with temporal lobe epilepsy and a nonlesional MRI, anterior temporal lobectomy can often render patients free of disabling seizures. It is generally accepted that epilepsy surgery is an excellent treatment option for achieving permanent seizure control in patients with temporal lobe epilepsies but it bears the risk of new and additional memory impairments after surgery [,, ]. The cognitive impact of TLE surgery on an ageing brain, with likely compromised function remains unclear. It represents the second most common procedure performed to treat pharmacoresistant epilepsy after temporal lobectomy (Janszky et al., 2000; Hosking, 2003). Temporal lobe resection, also called temporal lobectomy, is a surgery that can lower the number of seizures you have, make them less severe, or … The neuropsychological results of temporal lobe epilepsy surgery are well reported in the literature. Patients or parents graded their satisfaction with TLS. Citation: Mohan M, Keller S, Nicolson A, Biswas S, Smith D, Osman Farah J, et al. 1. This review summarizes recent evidence on the seizure, safety, cognitive and psychosocial outcomes of epilepsy surgery and their predictors. Significance: Clinical differences between adult and pediatric patients undergoing TLE surgery are reflected in differences in long-term outcomes and predictors of failures. Specialist services for epilepsy and intensive electroencephalography … Types of epilepsy surgery. Surgical treatment has been shown to be beneficial for the selected patients but fails to provide a seizure-free outcome in 20–30% of TLE patients. Contribution of neuropsychological data to the prediction of temporal lobe epilepsy surgery outcome. Earlier referral should be encouraged as it can improve surgical outcome. Pure lesionectomy was performed in 5 patients, extended lesionectomy with resection of the hemosiderin rim in 38 patients, and anterior temporal lobectomy in 9 patients with temporal lobe CCM.
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