Comparing Postsurgical Outcome of Patients with Intractable Epilepsy between Temporal and Extratemporal Lesions (P01.059)

Abstract

Objective: We compared postsurgical outcome of patients with intractable epilepsy between temporal and extratemporal lesions. Background The results of surgical treatment of epileptic seizures have gradually improved in the past decade, approaching 60% to 90% seizure-free outcome in temporal lobe epilepsy and 45% to 66% in extratemporal lobe epilepsy in most modern epilepsy centers. Design/Methods: Among 114 intractable epilepsy patients with localized epileptogenic zone according to surface EEG, LTM, fMRI and SPECT, 43 patients were considered for epilepsy surgery in Loghman hospital, Tehran, Iran. They were categorized to temporal and extratemporal lobe epilepsy. Two years outcome after surgery were evaluated using Engel classification and compared between aforementioned groups. Results: The mean age of patients at surgery was 23.8±10.3 years (range, 6-48 years). There were 23 male (53%) and 20 female patients (47%). Frequency distribution of seizure type was containing GTCS, CPS and others in 30%, 21% and 49%, respectively. Lesions were located in temporal and extratemporal in 19 (44%), 22 (51%) and 2 (5%), respectively. Outcome of surgery in temporal lesions was Engel Class I (10 case), Engel Class II (8 case) III (0 cases) or IV (1 case). In extratemporal lesions after surgery results were containing Engel Class I (11 case), Engel Class II (5 case) III (4 cases) or IV (2 case). There was no difference between two groups in Engel Class (p=0.093). Conclusions: About half of patients have been remained seizure free completely in our series. This result shows outcome of surgery in extratemporal lesions is as favorable as temporal ones. Disclosure: Dr. Amini Harandi has nothing to disclose. Dr. Sharifi has nothing to disclose. Dr. Shahmohammadi has nothing to disclose. Dr. Gharagozli has nothing to disclose. Dr. Pakdaman has nothing to disclose.