Surgical Results in Temporal Lobe Epilepsies Due to Structural Lesions

Objective: Temporal lobe epilepsy (TLE) is the most common localization-related epilepsy syndrome in adults. The aim of this study was to determine the long-term efficacy of epilepsy surgery in patients with TLE with focal lesions and to evaluate the predictive factors for seizure-free status after surgery. Methods: Among 109 patients aged more than 17 years, 26 cases with a postoperative follow-up period of at least 2 years and who underwent anterior temporal lobectomy and lesionectomy were included in the study. Each patient was evaluated with a detailed history, video-electroencephalography (EEG), neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom. Results: Patients with chronic TLE (n=26) associated with structural lesions were included in the study. According to Engel's classification, the seizure freedom rate was found to be 92.3% in the first year and 80.8% in the second year after surgery. At the postoperative 2nd year, demographic parameters, disease duration before surgery, mean age of patients, presence of focus to bilateral tonic-clonic seizure, EEG, video EEG monitoring, clinical lateralization, scanning results, surgical technique, and histopathological diagnosis did not demonstrate a significant difference between the seizure-free (Engel's class I) and non-seizure-free groups (Engel's class II, III, IV) (p>0.05). Conclusion: Refractory epilepsy surgery for temporal lobe tumors often offers complete seizure freedom. Complete surgical excision of the epileptogenic region is of great importance for achieving seizure-freeness.