Efficacy of temporal lobe surgery for epilepsy in patients with negative MRI for mesial temporal lobe sclerosis

Fernando L. Vale, Euclides Effio, Nicolas Arredondo, Ali Bozorg, Kondi Wong, Carlos Martinez, Katheryne Downes, William O. Tatum, Selim R. Benbadis

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Epilepsy surgery is a successful treatment for refractory temporal lobe epilepsy (TLE). Reports suggest fewer seizure-free outcomes for patients with TLE and who have a negative brain MRI (nMRI) for mesial temporal sclerosis. Data were collected prospectively from patients with nMRI who underwent temporal lobe surgery for TLE characterized by unilateral ictal temporal lobe seizure onset based on a scalp video electroencephalogram or invasive subdural electrode recordings. A total of 86 patients were followed for at least 24 months after surgery. Outcome was evaluated using the Engel classification. Seizure control was obtained by 55% (47/86) of patients (Class [CL]-I), 27% (23/86) showed significant improvement (CL-II) and 19% (16/86) were deemed surgical failures. Shorter duration of epilepsy, later onset of seizures, and ictal theta rhythm (5-7 Hz) were the most significant predictors of postoperative seizure control. Although hypometabolism on positron emission tomography scan and significant memory disparity (>2.5/8) were not significant prognosticators independently, cumulatively they were predictors for favorable outcome.

Original languageEnglish (US)
Pages (from-to)101-106
Number of pages6
JournalJournal of Clinical Neuroscience
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Keywords

  • Focal epilepsy
  • Nonlesional focal epilepsy
  • Normal brain MRI
  • Temporal lobe epilepsy
  • Temporal lobe surgery

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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  • Cite this

    Vale, F. L., Effio, E., Arredondo, N., Bozorg, A., Wong, K., Martinez, C., Downes, K., Tatum, W. O., & Benbadis, S. R. (2012). Efficacy of temporal lobe surgery for epilepsy in patients with negative MRI for mesial temporal lobe sclerosis. Journal of Clinical Neuroscience, 19(1), 101-106. https://doi.org/10.1016/j.jocn.2011.08.009