Type II complex partial seizures: poor results of anterior temporal lobectomy

Reasons why nine patients with Type II complex partial seizures continue to have disabling attacks after anterior temporal lobectomy were sought. Videotaped seizures revealed extratemporal features during onset of ictus, such as postural, contraversive head, eyes, and focal motor movements in four patients, and automatic ambulation, running, and motions similar to bicycling action or "bringing in a catch of fish" in five patients. Depth electrographic patterns also suggested a focus outside the hippocampus or amygdala in seven patients. Two patients had frontal lobe dysfunction on neuropsychological tests. Anterior temporal lobectomy is not indicated in Type II complex partial seizures.