Abstract
In Africa, epilepsy is a real burden. Temporal lobe epilepsy is the most common drug-resistant focal epilepsy disorder, and temporal lobectomy are the most common effective treatment on patients with drug-resistant epilepsy. We aim to highlight the Moroccan experience in epilepsy surgery and to ascertain its long-term outcome. Through the results of surgical treatment in our series, we expect to raise awareness of the need of epilepsy surgery in Africa and contribute to its development. We present a retrospective study of 132 patients who underwent surgery for epilepsy from January 2005 to December 2021 at our institution. The presurgical evaluation was based on clinical screening, interictal EEG, VEEG, neuropsychological tests, MRI and Pet Scan in some cases. Data are presented as the median and ranges. For all analyses, P-values < 0.05 were considered statistically significant. Our series includes 132 patients (69 males, 52.27%), median age at surgery was 24 years (range: 1-64). One hundred -fifteen patients (87%) were operated for temporal lobe epilepsy, among them, 98 (85%) had anterior temporal lobectomy, and 17 (15%) had a lesionectomy. Seventeen patients (13%) were operated for extratemporal epilepsy, among them, 4 had lesionectomy, 7 functional hemispherotomy, and 5 patients had Gamma Knife Stereotactic Radiosurgery. Our postoperative outcomes 3 months after surgery found 113 patients (85.6%), seizure-free (Engel I), 16 Engel II (12.1%), and 3 Engel III (2.3 %) in temporal lobe epilepsy. In extratemporal lobe epilepsy, 12 (70.5%) were Engel I, seizure-free, 4 Engel II (23.5%) and 1 Engel III (6%). These results confirm that a majority of patients with drug-resistant epilepsy may benefit from surgical treatment without submitting to preoperative invasive explorations. This should help develop epilepsy surgery widely in Africa.
Published Version
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