Experiences with Pharmacological Methods for the Lateralization of Temporal Epileptic Foci
Of 96 temporal lobe epileptics treated since 1950, only 55% responded favorably to medication (before carbamazepine). Of the rest, 75% had bilateral temporal spikes (independent or synchronous), 23% had unilateral spikes and 2% had a normal record, wake and sleep. Since the bilateral spike cases respond most poorly to medication, they would need most a new approach, such as surgery, to rehabilitate them. However, they are not doing as well after temporal lobectomy when compared to those who had unilateral spikes. Falconer 1 (1963) found the operation successful in only one out of ten bitemporal cases while two out of three of his unilateral spike patients did well. He concluded that it is best to exclude from surgical consideration all cases of bilateral temporal spikes approaching a 50/50 parity. The idea of bitemporal lobectomy including the hippocampus is generally discarded because of its predictable catastrophic effect on recent memory.
KeywordsTemporal Lobe Epilepsy Fast Activity Temporal Lobectomy Slow Spreading Seizure Discharge
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