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NEUROLOGY 1990;40:413
© 1990 American Academy of Neurology

Anterior temporal lobectomy for complex partial seizures

Evaluation, results, and long-term follow-up in 100 cases

T. S. Walczak, MD, R. A. Radtke, MD, J. O. McNamara, MD, D. V. Lewis, MD, J. S. Luther, MD, E. Thompson, RN, W. P. Wilson, MD, A. H. Friedman, MD and B. S. Nashold, MD

Departments of Medicine (Neurology) (Drs. Walczak, Radtke, and McNamara, and E. Thompson), Pediatrics (Dr. Lewis). Psychiatry (Dr. Wilson), and Surgery (Neurosurgery) (Drs. Friedman and Nashold), Duke University Medical Center, Durham, NC; and the Department of Neurology (Dr. Luther), University of Texas, San Antonio, TX.

We report evaluation and results in 100 patients who had undergone anterior temporal lobectomy for intractable complex partial seizures. Average follow-up was 9.0 years (range, 2 to 21 years). In the 2nd postoperative year, 63% were seizure free, 16% were significantly improved, and 21% were considered not significantly improved. Mean number of seizures in the last group was 27% of preoperative levels. Surgical results did not change significantly in subsequent postoperative years; good outcomes tended to persist over the longer term. We also examined the utility of continuous depth electrode monitoring in the evaluation of patients with independent bitemporal interictal epileptiform activity. Despite limited numbers of subjects in this category, there was a trend toward improved surgical outcome when such subjects were evaluated with depth electrodes.

Address correspondence and reprint requests to Dr. James McNamara, Box 2900, Duke University Medical Center, Durham, NC 27710.

Received February 24. 1989. Accepted for publication in final form August 14, 1989.






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