Introduction; Epilepsy is one of the most common neurological chronic disorders, with an estimated prevalence of 0. 5 – 1%. Partial focal epilepsy (PE) is one of the most common types of epilepsies that originates from a relatively limited number of neurons, whose malfunction generates epileptic attacks. Partial focal epilepsies make up 60% of the whole spectrum of epilepsies. Recent studies show that 25% of patient who suffer from PE show a resistance against medication. The duration of symptoms on the one hand and AED treatment on the other hand cause the cognitive dysfunctions in the patients suffering from epileptic seizures, especially children, to suffer progressive damage. Patients suffering from epilepsy have a cost that at the moment is difficult to calculate accurately, but it is still very high. Mesial Temporal lobe seizures are the most common form of partial epileptic seizures originating in the temporal lobe, and they are frequently resistant to anti-epileptic drug treatment.
Materials and Methods, At Neurosurgical Department, University Hospital “Mother Theresa”, since 2013 there is a team consisting of different medical specialists, for the study and selection of candidates, who can benefit from surgery. At the same time, since many years now in neurological department there is already a successful tradition in the medicament treatment of epilepsy.
The team of medical doctors in our Department, which makes the treatment of these diseases by means of surgery, is made up of: neuro-epileptologist, radiologists, neurologists, psychologists and neurosurgeons.
During the period, from 2013 until the year 2021, 35 patients have undergone an operation. All the patients were considered, based on protocols, as pharmacoresistant.
Conclusions; The post-surgical results were 80% of the patient’s seizure free and without need to use any antiepileptic treatment, meaning Engel 1. 15% of the patients were seizure free but with the need of antiepileptic treatment and meaning Engel 2 and 5% of patients were not able to be cured by achieving only a modification of the semiology of the crisis and frequency, meaning Engel 3.
Anterior temporal lobectomy in majority of the cases is the best surgical treatment of drug-resistant HS-TLE and long-term seizure free patients in this group have been reported about 70% (62-83%).
Fattorusso A, Matricardi S, Mencaroni E, Battista Dell'Isola G, Di Cara G. The Pharmacoresistant Epilepsy: An Overview on Existant and New Emerging Therapies. Front Neurol 2021 Jun 22; 12:674-483.
Kirsten M. Fiest, PhD* Khara M. Sauro, PhD* Samuel Wiebe, MD, MSc Scott B et al. Prevalence and incidence of epilepsy. A systematic review and meta-analysis of international studies. Neurology 2017 Jan 17; 88(3): 296–303.
Tassi L, Francione S, Mai R, Cardinale F, Cossu M, Lo Russo G. Indagini pre-chirurgiche e terapia chirurgica delle epilessie parziali: attivita del centro per la chirurgia dell epilessia “Claudio Munari”. EPILEPSY REVIEW - Anno IV - Numero 3 – 2000. 9-20
Shehryar R Sh, Kattan MW, Steinmetz M, Singer M. Cost-effectiveness of surgery for drug-resistant temporal lobe epilepsy in the US. Neurology 2020 Sep 8;95(10): 1404-1416.
Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Epilepsia. (2010) 51:1069–77.
Williamson PD, Thadani VM, French JA, Darcey TM, Mattson RM, et al. Medial temporal lobe epilepsy: videotape analysis of objective clinical seizure characteristics. Epilepsia 1998 Nov; 39 (11):1182-8.
Maillard L, Vignal JP, Gavaret M, Guye M et al. Semiologic and electrophysiologic correlations in temporal lobe seizure subtypes. Epilepsia. 2004 Dec;45(12):1590-9.
Chang EF, Englot DJ, Vadera S. Minimally invasive surgical approaches for temporal lobe epilepsy. Epilepsy Behav 2015;47: 24-33.
Mathon B, Bédos Ulvin L, Adam C, et al. Surgical treatment for mesial temporal lobe epilepsy associated with hippocampal sclerosis. Rev Neurol (Paris) 2015; 171(3): 315-25
Engel J Jr, Van Ness P, Rasmussen T. Outcome with respect to epileptic seizures. In: Engle J Jr, ed. Surgical Treatment of the Epilepsies. 2nd ed. New York, NY: Raven Press; 1993:609-621
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.