Анналы клинической и экспериментальной неврологии (Dec 2022)

Surgical outcomes in patients with drug-resistant bilateral temporal lobe epilepsy confirmed via magnetic resonance imaging

  • Vladimir V. Krylov,
  • Anna B. Gekht,
  • Anna V. Lebedeva,
  • Flora K. Rider,
  • Igor S. Trifonov,
  • Igor L. Kaimovsky,
  • Mikhail V. Sinkin,
  • Olga O. Kordonskaya,
  • Alexander A. Yakovlev,
  • Ilya G. Komoltsev,
  • Akhmed I. Magomedsultanov,
  • Rashid A. Navruzov

DOI
https://doi.org/10.54101/ACEN.2022.4.4
Journal volume & issue
Vol. 16, no. 4
pp. 29 – 37

Abstract

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Introduction. In patients with drug-resistant temporal lobe epilepsy (TLE), surgical treatment is aimed to resect an epileptogenic zone (EZ) followed by seizure control. Despite complicated EZ location, surgical resection should be considered as a treatment of choice in bilateral TLE. Objective: to evaluate surgical outcomes and factors contributing to outcomes in patients with drug-resistant bilateral TLE confirmed via magnetic resonance imaging. Materials and methods. The study included patients with unilateral (n = 50) and bilateral (n = 50) temporal lobe involvement. The results of surgical treatment were evaluated according to the classification of J. Engel (1993). Results. Favorable outcomes of surgical treatment (Engel I and Engel II) in the group with unilateral temporal lobe involvement were found in 98% of patients after 12 months, in 88% after 24 months, and in 100% after 48 and 60 months after surgery. In the group with bilateral temporal lobe involvement outcomes of surgical treatment were favorable in 41% of patients after 12 months, in 50% after 24 months, in 39% after 48 months, and in 50% of patients after 60 months post-surgery. Conclusion. Early onset, burdened perinatal history, and MRI-confirmed left temporal lobe involvement contribute to the poor outcome (Engel III and Engel IV) in the bilateral TLE group. Engel I outcomes were more common in the patients with unilateral TLE while Engel IIIV outcomes were more common in the patients with bilateral TLE.

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