Risk factors involving poor seizure prognosis of temporal lobe epilepsy--with special reference to neurosurgical approach.

Abstract

The consensus among experts in this field is that the majority of temporal lobe epilepsy (TLE) have proven to develop in childhood or adolescence, not infrequently accompanied by psychological and/or character disorders, and in particular resistant to pharmacotherapy, and thus culminating in difficulties in adapting to society during adulthood. Among various surgical procedures for different types of epilepsies, anterior temporal lobectomy has proven to bring about excellent effects; namely, more than 60% of patients who had undergone the operation became almost free from seizures.’ The object of this study is to look for the risk factors, which make the seizure prognosis of TLE unfavorable, by using the outcome of complex partial seizures (CPS) as an indicator in order to evaluate the surgical prognosis, and then to attempt a reappraisal on how those risk factors influence the surgical results based on reviewing the literature. In the discussion, it was emphasized that neurosurgery should be considered as part of a comprehensive management of epilepsy not in the terminal stage of epilepsy but in the early stage from the onset. And, in particular, the significance of presence of multiple foci that were exemplified by chronic depth