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Updated: May 29, 2026
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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Seizure outcomes following multilobar epilepsy surgery
Rani A Sarkis1, Lara Jehi, Imad M Najm
1Epilepsy Center/Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. rani_sa@yahoo.com
Epilepsia
|September 30, 2011
Summary
Multilobar epilepsy surgery can achieve seizure freedom in 41% of patients at 10 years. Predictors of seizure recurrence include resection type, preoperative auras, incomplete resection, and postoperative EEG spikes.
Area of Science:
- Neurosurgery
- Epileptology
- Clinical Neurology
Background:
- Long-term outcomes of unilobar epilepsy surgeries are established.
- Limited data exists on long-term seizure control after multilobar resections for refractory epilepsy.
Purpose of the Study:
- To determine long-term seizure control in patients undergoing multilobar epilepsy surgery.
- To identify predictors of seizure recurrence in this patient cohort.
Main Methods:
- Retrospective review of 63 patients undergoing multilobar epilepsy surgery (1994-2010).
- Survival analysis for seizure freedom and Cox proportional hazard modeling for recurrence predictors.
- Engel class I at last follow-up defined seizure freedom (minimum 6-month follow-up).
Main Results:
- 41% of patients remained seizure-free at 10 years post-surgery.
- Extended occipital resections showed more favorable outcomes compared to frontotemporal or temporoparietal resections.
- Predictors of recurrence included resection type, preoperative auras, incomplete resection, and postoperative EEG spikes.
Conclusions:
- Multilobar epilepsy surgery can yield favorable long-term seizure control in a significant portion of patients.
- Approximately one-third of patients experiencing breakthrough seizures can regain seizure freedom.
- Identifying recurrence predictors aids in surgical planning and patient counseling.
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