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Updated: Aug 23, 2026

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
11:29

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study

Published on: August 15, 2025

[Surgical treatment for temporal lobe epilepsy in patients over age 50 years]

Takato Morioka1, Kimiaki Hashiguchi, Kimiko Fukui

  • 1Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

No to Shinkei = Brain and Nerve
|July 9, 2004
PubMed

Insights

Anterior temporal lobectomy with hippocampectomy effectively treated intractable medial temporal lobe epilepsy (MTLE) in older adults. This epilepsy surgery led to significant seizure reduction and minimal complications in patients over 50.

Area of Science:

  • Neurosurgery
  • Epileptology
  • Neurology

Background:

  • Intractable medial temporal lobe epilepsy (MTLE) often requires surgical intervention.
  • Older adults with MTLE present unique considerations for treatment efficacy and surgical risk.

Observation:

  • A retrospective analysis of 4 patients aged 52-57 with intractable MTLE who underwent anterior temporal lobectomy with hippocampectomy.
  • Case 1 involved MTLE with a prior brain abscess; Cases 2-4 had MTLE with hippocampal sclerosis.
  • Patients experienced long-term seizures (26-37 years) without significant cognitive decline (IQ 87-100).

Findings:

  • All 4 patients achieved meaningful seizure reduction post-surgery, becoming seizure-free or experiencing rare seizures.
  • Surgical outcomes were positive, with patients returning to work or daily activities.
  • No significant postoperative complications were reported across the cohort.

Implications:

  • Anterior temporal lobectomy with hippocampectomy is a viable and effective treatment for intractable MTLE in older individuals.
  • The surgical procedure demonstrates a favorable risk-benefit profile for this demographic.
  • This study supports considering epilepsy surgery for elderly patients with refractory MTLE.

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