Long-term Outcomes After Nonlesional Extratemporal Lobe Epilepsy Surgery

Perspectives of epilepsy surgery in resource-poor countries: a study in Georgia

“…Persistent focal slowing in TLEs has a very high sensitivity to correct identification of the temporal origin of seizures [8]. Noe and colleagues found that the presence of interictal localized EEG discharges was the only non-invasive test associated with excellent outcome after surgery in extratemporal non-lesional epilepsy cases [24]. Similar results were observed in another study [5] that found that unilateral IEDs on scalp EEG were associated with an excellent outcome after amygdalohippocampectomy.…”

Treatment of resistant epilepsy

“…A recent retrospective study found that 28% of patients referred with drug-resistant MR scan-negative extratemporal lobe epilepsy underwent surgery: 33% were seizure free and 75% had a worthwhile seizure improvement a mean of 9 years after surgery. 18 Vagus nerve stimulators are surgically implanted batterypowered devices that repeatedly stimulate the vagus nerve. The devices are similar in size to cardiac pacemakers and are implanted in the upper chest with connecting wires attached to the left vagus nerve in the carotid sheath.…”

Review of Epilepsy - Etiology, Diagnostic Evaluation and Treatment

“…In addition, various neuro-radiological imaging techniques are employed to further identify the structural or functional epileptogenic lesion(s). Multiple studies have shown that the prognosis of epilepsy surgery varies depending on the etiology and location of the epileptogenic zone [43][44][45][46][47][48][49][50][51][60][61][62][63][64]. Radiographically identifiable epileptogenic lesions provide information about the etiology and localization of epilepsy, and can provide prognostic information for focal respective epilepsy surgery.…”

“…Radiographically identifiable epileptogenic lesions provide information about the etiology and localization of epilepsy, and can provide prognostic information for focal respective epilepsy surgery. Identifying a structural lesion on MRI provides an excellent prognosis from epilepsy surgery, with 60-90% freedom from disabling seizures [43][44][45][46][47][48][49][50][51][60][61][62][63][64]. Temporal lobe epilepsy is the most common type of epilepsy, and mesial temporal sclerosis (MTS) is the most common temporal lobe epilepsy [65].…”

“…When MRI fails to detect a potentially epileptogenic lesion, the chances of an excellent surgical outcome are significantly lower, ranging from 20-65% [40][41][42][43][44]. This may reflect the difficulty in localizing and resecting the epileptogenic zone [60]. In order to improve the radiographic detection of epileptogenic lesions, more advanced imaging techniques have been used such as 7T MRI, volumetric analysis, Diffusion Tensor Imaging (DTI), arterial spin labeling and PET [38,[66][67][68][69][70][71][72][73][74].…”