Temporal Lobe Resection for Epilepsy

Temporal lobe resection has long been established as a safe and effective epilepsy treatment for refractory temporal lobe epilepsy 1).

Temporal lobectomy has long been established as a safe and effective treatment for refractory temporal lobe epilepsy 2).

Anterior temporal lobectomy is curative for many patients with disabling medically refractory temporal lobe epilepsy, but carries an inherent risk of disabling verbal memory loss. Although accurate prediction of iatrogenic memory loss is becoming increasingly possible, it remains unclear how much weight such predictions should have in surgical decision making.

For patients with left temporal lobe epilepsy, quantitative assessment of risk and benefit should guide recommendation of therapy. In particular, risk for and potential impact of verbal memory decline should be carefully weighed against the degree of disability conferred by continued seizures on a patient-by-patient basis 3).

1) , 2)
Wiebe S, Blume WT, Girvin JP, Eliasziw M: A randomized, controlled trial of surgery for temporal lobe epilepsy. N Engl J Med 345:311–318, 2001
Akama-Garren EH, Bianchi MT, Leveroni C, Cole AJ, Cash SS, Westover MB. Weighing the value of memory loss in the surgical evaluation of left temporal lobe epilepsy: A decision analysis. Epilepsia. 2014 Sep 19. doi: 10.1111/epi.12790. [Epub ahead of print] PubMed PMID: 25244498.
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