Treatment outcome in hippocampal sclerosis with intractable epilepsy after temporal lobe resection in King Chulalongkorn Memorial Hospital
Keywords:
Hippocampal Sclerosis, Engelûs Classification, Seizure free, Non-Seizure free, Mesial temporal lobe epilepsy (MTLE), Anteromesial temporal lobectomy (AMTL)Abstract
Hippocampal sclerosis is the leading condition found in medically intractable temporal lobe epileptic patients for which temporal lobectomy is an effective treatment option. In this study, the authors sought to investigate the effectiveness and negative predictive factors of this surgical treatment at King Chulalongkorn Memorial Hospital. During 1 January 2011-30 June 2016, eighty-three patients (47 females and 36 males) underwent temporal lobectomy performed by the senior author. The mean age of the seizure onset and the mean age at time of surgery was 13.71 ± 7.99 and 37.34 ± 10.52 years, respectively. The mean duration of follow up was 3.25 ± 1.5 years. At two-year follow-up, there were 79 patients and their Engelûs classification postoperative outcome were I, II, III and IV in 72 (91.1%), 3 (3.8%), 0 (0%) and 4 (5.1%) patients, respectively. The negative predictive factors identified in non-seizure-free patients are poor medical and follow-up compliance, discordant EEG data, bilateral hippocampal sclerosis and a history of central nervous system infection. All of these findings are useful during preoperative patient counselling.
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