Temporal lobectomy for partial complex seizures: evaluation, results, and 1-year follow-up

Twenty-six patients were evaluated for temporal lobectomy. Fourteen underwent initial monitoring with electrodes in the amygdala and hippocampus bilaterally. Twelve had initial monitoring with scalp and sphenoidal electrodes. Four had conclusive localization without depth electrodes. Twenty-three patients underwent lobectomy. At 1-year minimum follow-up, 15 were seizure free. Five had greater than 90% reduction in seizure frequency. Complications of depth electrodes were one hemorrhage and one abscess. One patient developed impaired memory following surgery. Temporal lobectomy is effective in well-selected patients. Depth electrodes localize seizure onset from mesial temporal structures. Scalp and sphenoidal recording may be sufficient in some cases.