Surgical outcomes with non-invasive presurgical evaluation in MRI determined bilateral mesial temporal sclerosis: A retrospective cohort study

Abstract

Patients with bilateral MTS on MRI can be unilateral on electro physiology and neuropsychology, and can have a very good surgical outcome. In a setting of limited resources, a noninvasive pre-surgical protocol can be used. With proper patient selection, the outcomes may be comparable to those reported with invasive pre-surgical protocols. Patients with unilateral interictal and ictal EEG have the best outcome. Up to 50% patients with bilateral interictal discharges can have a seizure free outcome. Patients with bilateral independent seizure onset have a less favourable prognosis. Patients who are not seizure free can still attain worthwhile improvement in seizure frequency without significant decline in memory and some improvement in quality of life.

The phenotype of bilateral hippocampal sclerosis and its management in “real life” clinical settings

“…Importantly, the study collates data from multiple epilepsy centers, thereby reducing bias and better reflecting “real‐life” clinical practice across multiple countries. Previous work is summarized in Table , coupled with a summary of our data.…”

Combined Depth and Subdural Electrodes for Lateralization of the Ictal Onset Zone in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis

“…2023, 13, 1547 2 of 13 Efforts to reduce such failures and optimize surgical results remain a prominent clinical concern in the field of epilepsy management. There has been a compelling argument for considering a straightforward resection for MTLE-HS based on noninvasive lateralization, making conventional invasive electrode insertion less desirable [7][8][9]. However, in cases where there is uncertainty regarding the lateralization of the epileptogenic focus or suspicion of foci beyond the mesial temporal region, it is common practice to conduct invasive studies.…”