ABSTRACT
Objectives: To compare the efficacy and safety of anterior temporal lobotomy (ATLo) and anterior temporal lobectomy (ATLe) in drug-resistant temporal lobe epilepsy.
Methods: Patients diagnosed with pharmacoresistant temporal lobe epilepsy who underwent anterior temporal lobotomy (ATLo) or anterior temporal lobectomy (ATLe) performed by a single surgeon were retrospectively included. Every patient was followed up annually after surgery. The postoperative seizure outcome evaluation was based on the Engel and ILAE classifications. We compared postoperative complications and 2-year follow-up seizure outcomes between the ATLo group and the ATL group.
Results: A total of 42 individuals (21 ATLo and 20 ATLe) were included. At the two-year follow-up, more patients in the ATLo group than the ATLe group had reached Engel class I (20 versus 14) and ILAE I (19 versus 13). However, these differences were not significant. One patient in the ATLo group had intraparenchymal hematoma and fully recovered. The two groups had similar incidences of other short-term complications, and no patients died or had any permanent complications.
Discussion: ATLo is not inferior to ATLe for patients with drug-resistant temporal epilepsy. There was no significant difference in seizure outcomes or the rate of postoperative complications between the two groups. A large sample randomized control study is needed.
Acknowledgments
We would like to thank Dr. Hui You and Dr. Ruixue Cui who help with preoperative assessment.
Disclosure statement
No potential conflict of interest was reported by the authors.
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Notes on contributors
Xiyue Yang
Xiyue Yang and Qiao Yang were students of Peking Union Medical College, and they are interested in neurology and neurosurgery, now they have graduted.
Qi Liu
Qi Liu and Yi Guo are doctors of Department of Neurosurgery, PUMCH, having strong passion for functional neuroscience.
Qiao Yang
Xiyue Yang and Qiao Yang were students of Peking Union Medical College, and they are interested in neurology and neurosurgery, now they have graduted.
Jinzhu Guo
Jinzhu Guo is a nurse of department of neurosurgery, and she is good at intraoperative neuroelectrophysiological monitoring.
Yi Guo
Qi Liu and Yi Guo are doctors of Department of Neurosurgery, PUMCH, having strong passion for functional neuroscience.
Yiwei Zhang
Yiwei Zhang chooses neuroimaging as research interest.
Wanchen Dou
Wanchen Dou is the team leader of Neurosurgery Function Group, Peking Union Medical College Hospital (PUMCH). His research mainly focuses on functional neurosurgery, especially on preoperative evaluation and surgical treatment of epilepsy. He is also the first surgeon who perform anterior temporal lobotomy in China. His aim with this article is to show that anterior temporal lobotomy might be a good choice for temporal lobe epilepsy.