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Updated: Jun 9, 2026

Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
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Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note

Published on: June 13, 2016

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Presurgical entorhinal cortex volume and postoperative seizure outcome in temporal lobe epilepsy

Samia Elkommos1, Mark P Richardson2, Jan-Christoph Schoene-Bake3

  • 1Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.

Lancet (London, England)
|August 28, 2015
PubMed
Abstract

Insights

Reduced entorhinal cortex volume in patients with intractable mesial temporal lobe epilepsy (mTLE) does not predict surgical success. Further research is needed to understand factors influencing seizure outcomes after epilepsy surgery.

Area of Science:

  • Neurology
  • Neurosurgery
  • Epilepsy Research

Background:

  • Mesial temporal lobe epilepsy (mTLE) surgery is effective but fails in a third of patients.
  • Abnormalities in the entorhinal cortex are hypothesized to cause surgery-resistant mTLE.
  • Investigating presurgical entorhinal cortex volume as a predictor of surgical outcome.

Purpose of the Study:

  • To determine if presurgical entorhinal cortex volume predicts postoperative seizure control in patients with intractable mTLE.
  • To explore the association between entorhinal cortex volume and surgical outcomes.

Main Methods:

  • MRI scans of 78 patients with intractable mTLE and 76 healthy controls were analyzed.
  • Manual techniques were used to measure left and right entorhinal cortex volumes.
  • Postoperative outcomes were assessed using the International League Against Epilepsy (ILAE) classification.

Main Results:

  • Patients with mTLE showed reduced ipsilateral entorhinal cortex volumes compared to controls.
  • Right mTLE patients also exhibited reduced contralateral entorhinal cortex volume.
  • No significant differences in entorhinal cortex volumes were found between seizure-free patients and those with persistent seizures.

Conclusions:

  • Gross atrophy of the entorhinal cortex does not predict postoperative outcomes in intractable mTLE.
  • Further investigation into entorhinal cortex connectivity and resection extent is warranted.

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