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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
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Preoperative visual field deficits in temporal lobe epilepsy.

Sanjeet S Grewal1, William O Tatum2, Paul W Brazis3

  • 1Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.

Epilepsy & Behavior Case Reports
|March 29, 2017
PubMed
Summary

Preoperative visual field testing is crucial for epilepsy surgery patients. Subtle visual field defects like quadrantanopsia may be missed on routine exams but can indicate risks of surgical complications.

Keywords:
Laser thermoablationTemporal lobe epilepsyVisual field deficits

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Area of Science:

  • Neurosurgery
  • Ophthalmology
  • Epileptology

Background:

  • Medically refractory epilepsy is often treated with surgical resection or laser thermoablation.
  • These epilepsy surgeries offer good outcomes but carry inherent risks.

Observation:

  • A patient undergoing preoperative evaluation for epilepsy surgery was found to have a subtle visual field defect.
  • This defect, contralateral superior homonymous quadrantanopsia, was not detected during a routine neurological examination.

Findings:

  • The case highlights a potential complication of temporal lobe epilepsy surgery.
  • The subtle nature of the visual field defect underscores the limitations of standard neurological assessments.

Implications:

  • Advocates for more thorough preoperative visual field examinations in epilepsy surgery candidates.
  • Suggests a need to better understand the true incidence of visual field deficits following epilepsy surgery.