Tuesday July 4, 2006 15:00-17:00 Hall 5A Discussion Group Session The spectrum of temporal “plus” epilepsy

Abstract

Abstract 1 D. Schmidt ( 1 Epilepsy Research Group, Berlin, Germany ) Temporal lobe surgery is the nonpharmacological treatment of choice for carefully selected patients with drug resistant temporal lobe epilepsy. On average, two of three patients undergoing surgery will become seizure free or nearly seizure free after surgery with continued antiepileptic drug (AED) treatment. We limit our discussion to failure to achieve long term surgical seizure control which can occur in three groups of patients. One, surgery fails with respect to seizure control with continued AEDs in one of three cases who never become seizure free after surgery. Two, a small subgroup of patients who were seizure free after surgery on AEDs will not remain seizure free in the long run. This is another group of patients in whom surgery may be considered to have failed. When AEDs are stopped in patients who have been seizure free after temporal lobe surgery for several years, one in three patients has a seizure recurrence. This is a third subgroup of patients in whom surgery has failed, particularly in a small group in whom reinstitution of AEDs after seizure recurrence fails to regain seizure freedom. Despite all these instances of failure, temporal lobe surgery is a very useful procedure and the only one which achieves seizure freedom in 50% of patients with drug resistant temporal lobe epilepsy, approximately in 20% of patients with AEDs and in 30% without AEDs.