Medial temporal lobotomy in the treatment of medial temporal lobe epilepsy: a case series of 12 patients.

Abstract

Purpose: This case series aimed to investigate the safety and efficacy of medial temporal lobotomy (MTL) in the treatment of medial temporal lobe epilepsy (MTLE).

Methods: We presented our experience with 12 MTLE patients who underwent MTL in our center from January 2018 to July 2021. The MTL technique involves suction-based removal of the amygdala, effectively severing the fibrous connections between the medial temporal lobe structures and the surrounding cortex while maintaining the integrity of the medial temporal lobe structures without removing the hippocampus as in selective amygdalohippocampectomy.

Results: Among the 12 MTLE patients, five were men and seven were women. Mean age was 18.7 years-old, ranging from 6 to 41 years-old. All surgeries were completed successfully. Although one patient developed a transient mild disturbance of consciousness that fully resolved, no patient experienced intracranial hemorrhage, cerebral infarction, hemiplegia, aphasia, or visual field defect. Mean follow-up was 3.25 years, ranging from 6 to 41 years. The Engel classification for seizure outcomes at the last follow-up was as follows: class I, 9 patients (75.0%); class II, 1 patient (8.3%); and class III, 2 patients (16.7%).

Conclusion: Our preliminary results show that MTL is safe and effective. Future studies are warranted to validate our outcomes.