Microsurgical Treatment for Refractory Temporal Lobe Epilepsy:a Report of 102 Cases / 中国微创外科杂志

ABSTRACT

Objective To explore the effect of microsurgery for refractory temporal lobe epilepsy . Methods A retrospective analysis was made in 102 patients with refractory temporal lobe epilepsy from January 2005 to December 2011.The patients received comprehensive preoperative localization , intraoperative frontotemporal pterional incision , and microsurgical resection of epileptogenic focus .The efficacy was evaluated according to the Engel standards .Indications such as self-care ability, learning ability, and working ability were used to evaluate the quality of life , which were recorded and compared before and after operation . Results Follow-up was accomplished in all the 102 cases for a duration of 1 year and 9 months to 7 years.There were no mortality and serious complications .The effects evaluations at 1 year after operation showed complete disappearance of symptoms ( levelⅠ) in 61 cases (59.8%), almost disappearance (level Ⅱ) in 17 cases (16.7%), symptoms improvement more than 75% (level Ⅲ) in 13 cases (12.7%),and ineffective (level Ⅳ) in 11 cases (10.8%), bearing an effective rate of 89.2% (91/102) and a good-and-excellent rate of 76.5%(78/102).At one year and nine months postoperatively , 6 patients could not take care of themselves , 32 patients obtained partial self-care, and 64 patients had complete self-care,as compared with which there were 21 patients, 67 patients, and 14 patients preoperatively, respectively, having significant differences before and after surgery (Z =-7.001, P =0.000). Statistical significances were obtained before and after operation in 67 cases of children and adolescents with learning ability ( Z=-3.747, P =0.000) and in 35 adult cases with working ability ( Z =-2.564, P =0.010). Conclusions Microsurgical treatment is an effective method for refractory temporal lobe epilepsy .Patients ’ quality of life can get significant improvement after surgery.