No abstract available.
Anterior Temporal Lobectomy* ; Seizures*

We report a rare case of meningioangiomatosis in a 22 year-old man who has refractory partial seizures. Seven of 11 seizures had ictal onset zone at the perilesional medial and orbitofrontal areas of frontal lobe and 4 seizures arose from the mesial temporal area. After having lesion resection and an anterior temporal lobectomy with amygdalohippocam-pectomy, the patient no longer suffered from seizures. The epileptogenic foci were found not only in the intra-/peri-lesional area but also in remote area.
Anterior Temporal Lobectomy ; Epilepsy* ; Frontal Lobe ; Humans ; Seizures ; Young Adult

Ictal vomiting is a rare clinical manifestation of temporal lobe epilepsy. This manifestation is considered a clinical lateralizing sign pointing toward seizure activity within the nondominant temporal lobe. However, we have experienced a case of ictal vomiting associated with temporal lobe epilepsy within the dominant hemisphere. The ictal vomiting occurred early in the course of the seizure when rhythmic discharges predominantly involved the left temporal lobe. This patient underwent a left anterior temporal lobectomy and experienced markedly reduced seizure frequency for more than 2 years.
Anterior Temporal Lobectomy ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Seizures ; Temporal Lobe* ; Vomiting*

In terms of seizure control for the patients with medically intractable temporal lobe epilepsy(TLE), extensive medial resection, especially of the hippocampus, has been advocated in anterior temporal lobectomy. The relationship between the outcome of anterior temporal lobectomy for epilepsy and the size of the hippocampectomy tailored to intraoperative electrocorticographic findings was evaluated in 100 patients, with at least 12 months of follow-up. In 28 patients with small hippocampal resection(temporal lobe surgery underwent less resection of lateral temporal and hippocampus(p<0.001) compared to the patients with non-dominant temporal lobectomy. Intraoperative acute recording over the hippocampus and surrounding area can be useful in tailoring the extent of hippocampal resection to the individual pathophysiology.
Anterior Temporal Lobectomy* ; Classification ; Epilepsy ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Hippocampus ; Humans ; Seizures ; Temporal Lobe*

PURPOSE: To investigate the relationship of the resection extent of hippocampus and temporal neocortex with the postsurgical outcome in patients with mesial temporal lobe epilepsy (TLE). METHODS: Sixty-eight patients with TLE underwent brain MRI pre- and post-operatively. They were divided into two groups by seizure outcomes:seizure free group (SF, N=54) and non-seizure free group (NSF, N=14). Patients were classified further according to the post-surgical memory changes:MD group (with postsurgical memory decline, N=15) and NMD group (without postsurgical memory decline, N=16). The hippocampal resection was estimated by subtracting the length of post-surgical hippocampus from the pre-surgical length. The resection of temporal neocortex was measured by comparing the resection lengths on superior, middle, inferior and basal temporal gyri shown on three dimensional brain MRI. RESULTS: The mean extent of hippocampal resection was significantly larger in SF than in NSF (33.2+/-7.5 mm vs. 24.8+/-7.4 mm p=0.001) while that between MD and NMD was not significantly different. The resection extent of temporal neocortex was not significantly different between SF and NSF as well as between MD and NMD, but the resection extent of basal temporal gyrus of left TLE was significantly larger in MD than in NMD. CONCLUSIONS: The hippocampal resection was significantly greater in SF. The overall resection extent of the temporal neocortex did not correlate to the surgical outcomes of seizures or memory although that of the basal temporal gyrus of the left TLE was larger in MD.
Anterior Temporal Lobectomy* ; Brain ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory* ; Neocortex ; Seizures*

BACKGROUND: Patients with temporal lobe epilepsy (TLE) originating from different seizure onset zones had distinct electrophysiological characteristics and surgical outcomes. In this study, we aimed to investigate the relationship between the origin and prognosis of TLE, and the stereoelectroencephalography (SEEG) features. METHODS: Thirty patients with TLE, who underwent surgical treatment in our functional neurosurgery department from January 2016 to December 2017, were enrolled in this study. All patients underwent anterior temporal lobectomy after an invasive pre-operative evaluation with SEEG. Depending on the epileptic focus location, patients were divided into those with medial temporal lobe seizures (MTLS) and those with lateral temporal lobe seizures (LTLS). The Engel classification was used to evaluate operation effectiveness, and the Kaplan-Meier analysis was used to detect seizure-free duration. RESULTS: The mean follow-up time was 25.7 ± 4.8 months. Effectiveness was 63.3% for Engel I (n = 19), 13.3% for Engel II, 3.3% for Engel III, and 20.0% for Engel IV. According to the SEEG, 60.0% (n = 18) had MTLS, and 40.0% (n = 12) had LTLS. Compared with the MTLS group, the operation age of those with LTLS was significantly greater (26.9 ± 6.9 vs. 29.9 ± 12.5 years, t = -0.840, P = 0.009) with longer epilepsy duration (11.9 ± 6.0 vs. 17.9 ± 12.1 years, t = -1.801, P = 0.038). Patients with MTLS had a longer time interval between ictal onset to seizure (67.3 ± 59.1 s vs. 29.3 ± 24.4 s, t = 2.017, P = 0.008). The most common SEEG ictal pattern was a sharp/spike-wave rhythm in the MTLS group (55.6%) and low-voltage fast activity in the LTLS group (58.3%). Compared with the LTLS group, patients with MTLS had a more favorable prognosis (41.7% vs. 77.8%, P = 0.049). Post-operative recurrence was more likely to occur within three months after the operation for both groups, and there appeared to be a stable long-term outcome. CONCLUSION Patients with MTLS, who accounted for three-fifths of patients with TLE, showed a more favorable surgical outcome.
Anterior Temporal Lobectomy ; Electroencephalography ; Epilepsy, Temporal Lobe/surgery* ; Humans ; Stereotaxic Techniques ; Treatment Outcome

BACKGROUND: Patients with neocortical temporal lobe epilepsy(NTLE) are reported to have less favorable outcome with anterior temporal lobectomy, and the prognostic factors for patients with non-lesional NTLE are not well defined. METHODS: We analyzed the multiple potential predictors of outcome for 26 consecutive medically intractable non-lesional NTLE patients who have had both extracranial and intracranial EEG monitoring during their presurgical evaluation prior to surgery: age, age at seizure onset, sex, seizure semiology, seizure duration and frequency, an etiology, the site of the surgery, the region of intracranial ictal onset, intracranial amobarbital procedure, neuropsychology test, neuroimaging, multiple subpial transection(MST) and surgical pathology. The average follow up period was 37.0+/-11.1(range 20-60) months. The outcome factors analyzed were compared to two types of outcome group; seizure free group(class I) and persistent seizure group(class II-IV) according to Engel's classification. RESULTS: Seventeen of 26 non-lesional NTLE patients(65.4%) were seizure free during follow up. Intracranial ictal onset confined to anterior temporal region only significantly predicted seizure free(p<0.001). Earlier seizure onset(p=0.08) and resection without MST(p=0.10) tended to be seizure free, but not statistically significant. CONCLUSION: Patients with non-lesional NTLE can be a good candidate for a tailored anterior temporal neocorticectomy with/without MST after intracranial EEG monitoring and functional mapping.
Amobarbital ; Anterior Temporal Lobectomy ; Classification ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Humans ; Neuroimaging ; Neuropsychology ; Pathology, Surgical ; Seizures ; Temporal Lobe*

BACKGROUND: We investigated the neuropsychological features of laterality-sex interactions in mesial temporal lobe epilepsy (MTLE), using a broad and comprehensive neuropsychological test battery. METHODS: Eighty-nine consecutive patients (female 46) with MTLE (left 46) were included in the study. They underwent anterior temporal lobectomy and became seizure-free for at least one year postoperatively. All patients had a language dominancy in the left hemisphere. The following neuropsychological tests including : Korean Wechsler Intelligence Scale (KWIS), Wechsler Memory Scale-Revised (WMS-R), Wisconsin Card Sorting Test (WCST), and Color Trails Test (CTT), were performed preoperatively. Each variable of the neuropsychological tests were analyzed with regard to laterality-sex interactions. RESULTS: General memory, verbal memory, and delayed recall of WMS-R and a executive function measured by WCST were significantly decreased in patients with left MTLE compared to those with right MTLE. However, this laterality effect especially on verbal memory and some variables of WCST including the number of category completed was observed only in female patients. Interference index of CTT had a tendency to be increased in the male patients with right MTLE. The intelligence scale of KWIS was not correlated with lesion laterality or sex. CONCLUSIONS: Laterality-sex interactions were evident for verbal memory and an executive function in female patients with MTLE. Further studies need to be done on these neuropsychological features. (J Korean Neurol Assoc 19(2):132~138, 2001)
Anterior Temporal Lobectomy ; Epilepsy, Temporal Lobe ; Executive Function ; Female ; Humans ; Intelligence ; Male ; Memory ; Neuropsychological Tests ; Temporal Lobe* ; Wisconsin

BACKGROUND: We investigated the neuropsychological features of laterality-sex interactions in mesial temporal lobe epilepsy (MTLE), using a broad and comprehensive neuropsychological test battery. METHODS: Eighty-nine consecutive patients (female 46) with MTLE (left 46) were included in the study. They underwent anterior temporal lobectomy and became seizure-free for at least one year postoperatively. All patients had a language dominancy in the left hemisphere. The following neuropsychological tests including : Korean Wechsler Intelligence Scale (KWIS), Wechsler Memory Scale-Revised (WMS-R), Wisconsin Card Sorting Test (WCST), and Color Trails Test (CTT), were performed preoperatively. Each variable of the neuropsychological tests were analyzed with regard to laterality-sex interactions. RESULTS: General memory, verbal memory, and delayed recall of WMS-R and a executive function measured by WCST were significantly decreased in patients with left MTLE compared to those with right MTLE. However, this laterality effect especially on verbal memory and some variables of WCST including the number of category completed was observed only in female patients. Interference index of CTT had a tendency to be increased in the male patients with right MTLE. The intelligence scale of KWIS was not correlated with lesion laterality or sex. CONCLUSIONS: Laterality-sex interactions were evident for verbal memory and an executive function in female patients with MTLE. Further studies need to be done on these neuropsychological features. (J Korean Neurol Assoc 19(2):132~138, 2001)
Anterior Temporal Lobectomy ; Epilepsy, Temporal Lobe ; Executive Function ; Female ; Humans ; Intelligence ; Male ; Memory ; Neuropsychological Tests ; Temporal Lobe* ; Wisconsin

BACKGROUND: There exist considerable debates concerning about the effects of epilepsy surgery on cognitive function. To evaluate the effects of tailored anterior temporal lobectomy with amygdalohippocampectomy (ATLAH) on intelligence and memory, we compared the pre- and post-operative cognitive function in patients with mesial temporal lobe epilepsy (MTLE). METHODS: Thirty six patients who received unilateral tailored ATLAH from 1993 to 1997 and had been seizure-free for at least two years postoperatively were selected. Mean age at the time of surgery was 26.8 years and mean period of postoperative follow-up was 47 months. The change of cognitive function was assessed pre-and post-operatively using Korean Wechsler Adult Intelligence Scale (K-WAIS) and Rey memory test. We also assessed the correlation between the extent of hippocampal and lateral temporal cortical resection and cognitive changes respectively. RESULTS: In total patients (N=36), there was statistically significant improvement in performance IQ (PIQ, p<0.05), full scale IQ (FIQ, p<0.05), and auditory verbal learning test (AVLT). In the right temporal lobectomy group (N=16), improvement in PIQ, FIQ, and AVLT reached to statistical significance (p<0.05). In the left temporal lobecto-my group (N=20), improvement in PIQ was significant (p<0.05). In terms of the size of resection, there were tendencies that the cognitive function is more improved in patients with larger hippocampal resection (>2 cm) and in patients with smaller temporal cortical resection (4 cm). CONCLUSIONS: Patients became seizure free after tailored ATLAH may have improvement in performance IQ and full scale IQ. Right side resection, larger hippocampal resection, and smaller lateral temporal resection show better postoperative cognitive function. (J Korean Neurol Assoc 19(2):116~124, 2001)
Adult ; Anterior Temporal Lobectomy* ; Epilepsy ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Humans ; Intelligence* ; Memory* ; Seizures ; Temporal Lobe* ; Verbal Learning