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Vol. 13. Issue 1.
Pages 33-37 (January 2002)
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Vol. 13. Issue 1.
Pages 33-37 (January 2002)
Surgical treatment of temporal lobe epilepsy. Personal Experience
Tratamiento quirúrgico de la epilepsia del lóbulo temporal. Experiencia personal
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A. Faleh-Tamimi
, A. Qudah
Section of Neurosurgery and Clinical Neurophysiological Unit. Hospital of Jordán University. Ammán. Jordán
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Summary

The authors present their results with epilepsy surgery of the temporal lobe performed during a 5 years period at the Hospital of the University of Jordán, in 12 patients. All patients underwent comprehensive presurgical evaluation, including neurological history, examination, video-Electroencefalogram, Electroence-phalogram for intercritical and habitual seizures and optimum magnetic resonance. After appropriate selection, we performed epilepsy surgery in 12 patients (9 males and 3 females). The mean age at operation was 21,4 years (range 4–44 years). All patients were receiving high therapeutic doses of antiepileptic therapy. Abnormal findings in Magnetic Resonance were obser-ved in all cases. Pre and post resection electrocorticogram were recorded and graded according to Jay Scale. Pathological findings showed, neoplasic lesion in 2 cases (16%); one ganglioglioma and a low grade astrocytoma) and 10 patients (84%) showed non-neoplasic lesions. Three patients (25%) had cortical dysplasia, another 3 (25%) had mesotemporal sclerosis, three more (25%) gliosis and one (8%) an arachnoid cyst. Post resection ECoG showed (84%) type A, (8%) type B, and (8%) type C. The present study has shown that intraoperative ECoG has an important role in the prediction of medically intractable epilepsy. Outcome of temporal lobe epilepsy surgery in our series was comparable to results reported by other authors despite of the absence of sophisticated functional tests.

Key words:
Temporal lobe epilepsy
Seizure
Temporal lobectomy
Electrocorticography
Epilepsy surgery
Resumen

Los autores analizan los resultados de la cirugía de la epilepsia del lóbulo temporal en 12 pacientes tratados a lo largo de 5 años en el hospital de la Universidad Jordana de Amman. Todos los pacientes fueron sometidos a una evaluación prequirúrgica, incluyendo historia neurológica, examen clínico, electroencefalograma bajo control de video electroencefalograma para la actividad intercrítica y resonancia magnética. La elección quirúrgica fue realizada en 12 pacientes (9 mujeres y 3 varones), la edad media fue de 21 años, oscilando entre 4 y 44 años, todos ellos habían recibido dosis altas de poliquimioterapia antiepiléptica. La resonancia magnética fue anormal en todos los casos.

Se realizó electrocorticografía antes y después de la resección utilizando la escala de Jay. Los estudios histológicos mostraron hallazgos neoplásicos en 2 casos (16%); un caso de ganglioglioma y otro de astrocitoma de bajo grado. Diez pacientes (84%) no mostraban lesiones neoplásicas. Tres (25%) tenían displasia cortical, tres (25%) esclerosis mesotemporal, dos (16%) gliosis, y un paciente (8%) con quiste aracnoideo. La electrocorticografía post-reseccion mostró 84% tipo A, 8% tipo B, y otro 8% tipo C. El presente estudio demostró que el uso de la electrocorticografía tiene valor predictivo del pronóstico postoperatorio y que en general el resultado de la cirugía del lóbulo temporal es favorable.

Palabras clave:
Epilepsia
Crisis
Lobectomía temporal
Electrocorticograiía
Cirugía

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