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Contenidos del congreso
XXIII Congreso Nacional de la Sociedad Española de Neurocirugía
Salamanca, 14-17 Mayo 2019
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V. Krylov1, I. Trifonov1 and O. Kordonskaia2

1Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia. 2Sklifosovsky Research Institute of Emergency Care, Moscow, Russia.

Objectives: To evaluate the results of surgical treatment of patients with drug-resistant temporal lobe epilepsy.

Methods: Prospective analysis of 97 patients (35 women and 62 men) with temporal lobe epilepsy, who had undergone resective surgerybetween 01.01.2014 and 01.02.2018 was carried out. The study included adults with an average age over 35 years. The average disease duration was at least 12 years. The surgical outcomes (assessed by Engel's classification), complication rate, magnetic resonance imaging (MRI) results, and pathohistology results were analyzed.

Results: Of the total study population; 71 patients (69.6%) had temporal lobe epilepsy, while the remaining 26 patients (30.4%) had temporal plus epilepsy. Fifty patients had lesions on MRI, 47 were MRI negative. Intracranial video electroencephalogram recordings were carried out for 40 patients (39%), with an average duration of 97.1 hours. All 97 patients were surgically treated. There was no surgical mortality. One patient (1%) had transient mild hemiparesis and in one case the history of disease was complicated by meningitis. At evaluation 12 months after surgery; 57 patients (58%) were seizure free; 45 patients (46%) were classified as Engel Ia, six (6%) as Engel Ib, six (6%) as Engel Id, five (5%) as Engel IIa, and 16 (17%) as Engel IIb. Unsatisfactory results of treatment were noted for 19 patients: nine (10%) were classified as Engel IIIa, five (5%) as Engel IVa, and five (5%) as Engel IVb. Histological examination revealed 12 patients (12%) to have focal cortical dysplasia (FCD) type 1a, 19 (20%) FCD 1c, 10 (10%) FCD IIa, one (< 1%) FCD IIb, 35 (36%) FCD IIIa, four (4%) FCD IIIc and 16 (17%) had FCD IIId.

Conclusions: Our results confirm the efficiency and safety of surgical treatment for drug-resistant temporal lobe epilepsy, with 58% patients becoming seizure free within 12 months.


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