Temporal lobe resection for intractable epilepsy: review of 11 cases

GKK Leung, YW Fan, KY Fong
Division of Neurosurgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong

OBJECTIVE. To review the management of medically intractable epilepsy by performing temporal lobe resection.

DESIGN. Retrospective study.

SETTING. University teaching hospital, Hong Kong.

PATIENTS. Eleven patients: seven women and four men (mean age, 28 years; range, 19-49 years) who underwent temporal lobe resection for intractable epilepsy from 1994 through 1998.

MAIN OUTCOME MEASURES. Preoperative and operative aspects of treatment, postoperative complications, mortality, and seizure control before and after surgery.

RESULTS. All but one patient had long-standing medically intractable temporal lobe epilepsy; the duration between the onset of seizure and surgery ranged from 12 to 27 years (mean, 17.2 years). A total of 12 resections were performed without any mortalities or major postoperative complications. After surgery, two patients became seizure-free without the need for antiepileptic medication; six patients were seizure-free but required medication; and two patients showed >90% of improvement in seizure control, whereas one patient showed between 50% and 90% of improvement. Nine (81%) of the 11 patients reported significant improvement in their social life and performance of daily activities. Two (18%) patients, including one with improved seizure control, reported no improvement in their performance of daily functions.

CONCLUSIONS. Temporal lobe resection can produce significant improvements in patients who have medically intractable epilepsy. The risks of surgery are relatively small and justifiable.

Hong Kong Med J 1999;5:329-36

Key words: Brain diseases; Epilepsy/surgery; Epilepsy, temporal lobe; Temporal lobe/surgery; Treatment outcome