TY  - JOUR
TI  - Long-Term Surgical Outcomes and Predictors of Surgical Treatment in
Temporal Lobe Epilepsy
AB  - Background: Surgical treatment of epilepsy is a favored modality in the
management of refractory temporal lobe epilepsy (TLE) and known to be quite
effective. The aim of this study was to evaluate the long‑term outcomes in surgical
treatment of TLE and to identify prognostic factors influencing postoperative seizure
remission. Materials and Methods: The patients who underwent anterior temporal
lobectomy (ATL) with the diagnosis of refractory TLE in our center between the
years of 2006 and 2020 were included. Preoperative workup process was carried
out by a multidisciplinary team and consisted of neuropsychological examination,
long‑term electroencephalography, brain magnetic resonance imaging (MRI), and
fluorodeoxyglucose positron emission tomography (FDG‑PET) for each patient.
Postoperative assessment of seizure control was repeated every year following
surgery and categorized according to Engel’s outcome classification. The predictive
value of baseline demographic, clinical, laboratory, imaging, and histopathological
parameters on postoperative seizure control was also evaluated. Results: One
hundred and forty‑three patients who underwent ATL with the diagnosis of TLE
were included. According to Engel’s classification, the seizure freedom rate was
found to be 83.2% at the 2nd year, 81.3% at the 4th year, and 79.2% at the 10th year
after surgery. In the univariate analysis, febrile seizure (FS) history, unilateral
interictal epileptiform discharges (IEDs), hippocampal sclerosis (HS) on MRI,
unilateral temporal hypometabolism (HM) on FDG‑PET, and HS in histopathology
were predictors of seizure control at the postoperative 2nd and 10th years. FS history,
unilateral localization of IEDs, and unilateral FDG‑PET findings of temporal HM
were found to be the independent predictors of postoperative seizure control on
multivariate analysis. Conclusions: In the current study, we revealed that epilepsy
surgery provides effective seizure control and represents a beneficial therapeutic
option in refractory TLE. Our results also suggested that FS history, unilateral
IEDs, and unilateral FDG‑PET findings of temporal HM were independent
predictors of seizure remission in these patients.
AU  - yıldırım, İrem
AU  - Bilir, Erhan
AU  - GÜRSES, Aslı AKYOL
AU  - ATAOĞLU, Esra ERKOÇ
AU  - ATAY, Lütfiye Özlem
AU  - HİRFANOĞLU, Tuğba
AU  - ONER, Ali Yusuf
AU  - SERDAROĞLU, Ayşe
AU  - KURT, Gökhan
AU  - AKDEMİR, Ümit Özgür
DO  - 10.4103/nsn.nsn_200_21
PY  - 2021
JO  - Neurological sciences and neurophysiology (Online)
VL  - 38
IS  - 4
SN  - 2636-865X
SP  - 209
EP  - 218
DB  - TRDizin
UR  - http://search/yayin/detay/511757
ER  -