The Preoperative Electroclinical Evaluation Determines Postoperative Seizure Control after Temporal Lobectomy
We have tested the hypothesis that the outcome of temporal corticectomy for seizure control is a function of the clinical and electrophysiological methodology employed in case selection in 25 consecutive cases of temporolimbic seizures from a study population of 68 sequential patients with medically intractable epilepsy who had received complete in-hospital neurological, neuropsychiatry, radiological, extracranial EEG, and stereoelectroencephalographic (SEEG) assessment. The relatively low published rates of complete seizure control (30%–40% seizure-free) after temporal lobectomy (Jensen 1975; Rasmussen 1975) indicate the limitations of seizure control consequent to reliance on interictal extracranial EEG recording for selection of surgical candidates. Our methodology comprised three aspects: surgical philosophy, surgical selection criteria, and indications for SEEG.
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