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: Memory changes and its predictors after anterior temporal lobectomy (ATL) were investigated. A standardized regression-based (SRB) outcome methodology was used, accounting for the effects of practice and preoperative memory functions. METHODS: Consecutive 45 ATL patients (male 22) with mesial temporal sclerosis (dominant 21) who became seizure-free for at least 1 year postoperatively were included in the study. Wechsler Memory Scale-Revised(WMS-R) was performed pre- and postoperatively. Memory changes were estimated using SRB norms and then were correlated with age of onset, seizure duration, chronological age, seizure risk factors, and preoperative memory function. RESULTS: 1) The majority of cases (76~84%) showed no significant memory changes. Significant declines in verbal memory were noted for 8 (18%) out of 45 ATL patients whereas significant declines in visual memory were found in only 2 (4%). There were no differences in memory changes according to lesion laterality. 2) Later age at onset, shorter duration of epilepsy, absence of history of infection or febrile convulsion were significantly related to verbal memory decrease after ATL. 3) Using SRB methodology, adequacy of preoperative memory performance was correlated with decrease in visual memory but not in verbal memory, even if absolute change scores between pre-and postoperative values were associated with preoperative performances in both verbal and visual memory. CONCLUSIONS: Although group variability of memory outcome after ATL using WMS-R was not found to be significant, considerable individual variability of memory outcome after ATL was found along with significant predictors of postoperative verbal memory decrease. (J Korean Neurol Assoc 19(3):219~225, 2001)
Age of Onset ; Anterior Temporal Lobectomy ; Epilepsy, Absence ; Epilepsy, Temporal Lobe* ; Humans ; Memory ; Risk Factors ; Sclerosis ; Seizures ; Seizures, Febrile ; Temporal Lobe*

OBJECTIVE: The increasing use of sensitive neuroimaging techniques has demonstrated that significant percentage of patients with intractable complex partial seizures have brain masses, especially in temporal lobe. The optimal surgical solution for these patients is still open to debate. The purpose of our investigation is to evaluate the surgical outcome of patient with lesion-related temporal lobe epilepsy with respect to the types of surgery and the location of lesion. PATIENTS AND METHODS: From DEC. 1993 to Dec. 1997, 35 patients with intractable epilepsy and space occupying temporal lobe lesion identified in preoperative MRI were included in this study. The types of surgery were lesionectomy, anterior temporal lobectomy with or without hippocampectomy. The location of lesion was divided as anteromedial group and lateral cortical group. The postoperative seizure outcomes according to the type of surgery and location of the lesion were compared. RESULTS: Twenty-six of 34 patients(76.5%) were seizure-free after surgery. The Engel's class was favorable after anterior temporal lobectomy with or without hippocampectomy(p=.044). CONCLUSION: It is favorable to perform anterior temporal lobectomy for the treatment of intractable epilepsy with space-occipying lesion in temporal lobe. The resection of the hippocampus can be individualized.
Anterior Temporal Lobectomy ; Brain ; Epilepsy ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Seizures* ; Temporal Lobe*

BACKGROUND: The aim of this study was to identify factors predicting intellectual and memory changes following anterior temporal lobectomy (ATL) for mesial temporal lobe epilepsy (TLE). METHODS: The sample consisted of 31 patients who underwent ATL for treatment of medically intractable TLE. All patients were administered intellectual and memory tests preoperatively and postoperatively. RESULTS: All statistically significant intellectual and memory changes at 1-year follow-up were in the direction of improvement. Left vs. right ATL had significantly differential effects on verbal intelligence and verbal memory, reflecting greater decline (or less improvement) following a left ATL. A later onset age of seizures, an older age at surgery, and a higher presurgical cognitive performance predicted a greater cognitive decline following an ATL. CONCLUSIONS: At 1-year after ATL, most cognitive functions showed either no significant changes or significant changes in a favorable direction. Decreased verbal functions following a left ATL was the area of greatest potential neuropsychological morbidity associated with ATL. Greater cognitive decline following ATL was predicted by later onset age of recurrent seizures, older age at time of surgery, and higher presurgical cognitive performance.
Age of Onset ; Anterior Temporal Lobectomy* ; Epilepsy, Temporal Lobe* ; Follow-Up Studies* ; Humans ; Intelligence ; Memory* ; 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