Seizure Outcome after Temporal Lobectomy in Temporal Lobe Cortical Dysplasia

Authors


Address correspondence and reprint requests to Dr. W.E. Bingaman at Department of Neurosurgery, S-80, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, U.S.A. E-mail: bingamb@ccf.org

Abstract

Summary: Purpose: To identify the temporal lobe cortical dysplasia (CD) histopathology classification subtype and determine the seizure outcome of patients who underwent temporal lobectomy with coincident CD.

Methods: We reviewed the data of 28 patients with temporal lobe epilepsy who underwent surgery with pathologically verified CD at our institution from 1990 to 2000. The seizure outcome was assessed at a minimum of 1 year after surgery according to Engel's classification.

Results: Of 28 patients who underwent surgery, nine (32.1%) had isolated CD, and 19 (67.9%) had CD and hippocampal sclerosis (CD&HS). Twenty-six (92.9%) patients had histopathology subtype Ia (architectural abnormalities). Twenty (71.4%) patients were seizure free (Engel class I). Favorable seizure outcome (Engel class I, II) was achieved in 26 (92.9%) patients. No difference in seizure outcome was noted between patients with CD and CD&HS.

Conclusions: The most common histopathologic subtype in patients with temporal lobe CD is type Ia (architectural abnormalities). Temporal lobectomy in temporal lobe epilepsy patients with CD can achieve favorable seizure outcome.

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