Abstract
Introduction: Surgery for refractory temporal lobe epilepsy (TLE) has been a well-defined procedure to provide seizure control in the recent years. Objective: The aim of the present study is to evaluate seizure outcome of patients with TLE and bilateral mesial temporal sclerosis (bMTS) after cortico-amygdalohippocampectomy compared with those presenting unilateral (uMTS) lesions. Method: A case-controlled study was conducted in patients with TLE and bMTS or uMTS treated in the epilepsy clinic of the Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), a Brazilian tertiary referral epilepsy center, from January 2000 to March 2012. Patients with neuroradiological evidence and/or neuropathological confirmation of other diseases than MTS, as well as additional potential epileptogenic MRI-lesions, were excluded from the study. Results: During this period, 533 patients underwent multidisciplinary investigation of epilepsy and 229 (43%) fulfilled criteria to be included in the present study, 60 (26.2%) with bMTS and 169 (73,8%) with uMTS. Thirty-seven (61.6%) were classified as Engel I in bMTS group, while 107 (63.3%), were classified as Engel in uMTS group. There was no mortality in both groups. Conclusion: The present data highlight that a favorable seizure outcome can also be obtained in patients with bMTS after adequate pre-surgical evaluation.
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