Surgical treatment of temporal lobe epilepsy. Personal experience

The authors present their results with epilepsy surgery of the temporal lobe performed during a 5 years period at the Hospital of the University of Jordan, in 12 patients. All patients underwent comprehensive presurgical evaluation, including neurological history, examination, video-Electroencefalogram, Electroencephalogram for intercritical and habitual seizures and optimum magnetic resonance. After appropriate selection, we performed epilepsy surgery in 12 patients (9 males and 3 females). The mean age at operation was 21.4 years (range 4-44 years). All patients were receiving high therapeutic doses of antiepileptic therapy. Abnormal findings in Magnetic Resonance were observed in all cases. Pre and post resection electrocorticogram were recorded and graded according to Jay Scale. Pathological findings showed, neoplasic lesion in 2 cases (16%); one ganglioglioma and a low grade astrocytoma) and 10 patients (84%) showed non-neoplasic lesions. Three patients (25%) had cortical dysplasia, another 3 (25%) had mesotemporal sclerosis, three more (25%) gliosis and one (8%) an arachnoid cyst. Post resection ECoG showed (84%) type A, (8%) type B, and (8%) type C. The present study has shown that intraoperative ECoG has an important role in the prediction of medically intractable epilepsy. Outcome of temporal lobe epilepsy surgery in our series was comparable to results reported by other authors despite of the absence of sophisticated functional tests.