RESULTS OF THE TEMPORAL LOBE EPILEPSY SURGERY IN A DEVELOPING COUNTRY
Abstract number :
3.250
Submission category :
Year :
2002
Submission ID :
1566
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Walter H. Silva, Damian Consalvo, Patricia Solis, Pablo A. Salgado, Brenda Giagante, Silvia A. Oddo, Luciana DAlessio, Estela Centurion, Patricia Saidon, Alejandra Rabadan, Ricardo Vazquez, Eduardo Seoane, Silvia Kochen. Epilepsy Center,Department of Neur
RATIONALE: Surgical treatment seems to be the best option for patients with refractory symptomatic temporal lobe epilepsy (TLE). The aim of this study was to analyze the surgical results in a population of patients from Ramos Mej[iacute]a hospital in Buenos Aires, Argentina, that were operated between October 1996 to March 2001. At the end of this activity the participants should be able to discuss about the outcome after surgery in temporal lobe epilepsy in a country with limited resources.
METHODS: We selected 24 patients who were operated due to a diagnosis of medically intractable TLE and who had, at least, 1 year of postsurgical follow-up. All the patients were evaluated using a multidisciplinary approach that include a complete medical and neurological history, outpatient EEG, MRI of the brain, neuropsychological tests and Video-EEG. Intracarotid amobarbital test was performed in only 1 patient. Deep electrodes were implanted in one patient, in both temporal lobes, in order to lateralize the epileptogenic zone. Seizure outcome was assessed using Engel[ssquote]s classification.
RESULTS: There were 14 females and 10 males, mean age 36 years. In 22 patients an anterior temporal lobectomy (ATL) was performed, and in 2 patients a lesionectomy was done. Twelve patients were operated on the right side and 12 on the left side. The histopathological findings showed a low-grade tumor in 4 patients, hippocampal sclerosis in 17, dual pathology in 2 and cavernous angiomas in 1 patient. The mean follow-up period was 3,4 years (range 1-5 years). Nineteen patients (79.2 %) were in class I, 2 patients were in class II, 2 patients were in class III and 1 patient was in class IV.
CONCLUSIONS: Our results showed a postoperative outcome comparable with series of developed countries. The number of patients that were operated during the period of analysis was significantly lower than the potential candidates. The implementation of an surgical epilepsy program in public hospitals in our country is necessary to increase the number of patients who benefits with this kind of therapy.
[Supported by: CONICET-UBA.]