Kalybaeva NA, Dimertsev AV, Mazalova MV, Kuzovkina AK, Altunina GE, Odeniyazova MA, Balatskaya AS, Utyashev NP, Bychenko VG, Bronov OY, Pedyash NV, Zemlyansky MY, Kopachev DN, Zuev AA, Golovteev AL. [Surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele].
Zh Vopr Neirokhir Im N N Burdenko 2024;
88:39-47. [PMID:
38334729 DOI:
10.17116/neiro20248801139]
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Abstract
BACKGROUND
In recent years, temporal lobe encephalocele has become more common in patients with focal drug-resistant epilepsy. Despite available experience, there are still no clear recommendations for choosing the extent of surgery in these patients.
OBJECTIVE
To evaluate the effectiveness of diagnosis and surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele.
MATERIAL AND METHODS
The study included 21 patients with focal temporal lobe epilepsy and temporal lobe encephalocele. All patients underwent continuous video-EEG monitoring and MRI of the brain. There were 12 (57.4%) selective encephalocele resections and 9 (42.6%) anterior temporal lobectomies. The median follow-up period was 31 months.
RESULTS
The overall effectiveness of surgical treatment with postoperative Engel class I was 76% (16 cases). Selective encephalocele resection was followed by postoperative Engel class I in 10 patients (83%). There were 6 (67%) patients with similar outcomes after temporal lobectomy. Mean volume of resected tissue adjacent to encephalocele was 8.3 cm3.
CONCLUSION
Surgery is a highly effective treatment for patients with epileptic seizures following temporal lobe encephalocele. In our sample, favorable postoperative outcomes were achieved in 76% of patients (Engel class I). There were no significant differences in effectiveness between selective resection and temporal lobectomy. Further research is necessary for a clear protocol of surgical treatment of focal drug-resistant epilepsy associated with encephalocele.
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