Resistant Temporal Lobe Epilepsy: Initial Steps into a Bigger Epilepsy Surgery Program.

xlomafota13 shared this article with you from Inoreader Resistant Temporal Lobe Epilepsy: Initial Steps into a Bigger Epilepsy Surgery Program. Via leak of cerebrospinal fluid Related Articles Resistant Temporal Lobe Epilepsy: Initial Steps into a Bigger Epilepsy Surgery Program. J Neurosci Rural Pract. 2021 Jan;12(1):193-196 Authors: Mehrotra A, Singh S, Kanjilal S, Attri G, Rangari K, Paliwal VK, Mani V, Verma PK, Maurya VP, Sardhara J, Bhaisora KS, Das KK, Srivastava AK, Jaiswal AK, Behari S Abstract Background  Among the patients of drug-resistant epilepsy, a subset which has focal impaired seizures localizes to the temporal lobe region (TLE). A majority of these cases are surgically amenable with anterior-medial temporal lobe resection or "lesionectomy." Objective  In India, there is scarcity of "specialized centers" providing "comprehensive epilepsy care" and this dearth is further worse in populous states. In this article, we share our single center, observational, and retrospective experience of TLE in background of limited resources and utmost requirement. Methodology  Our study is a retrospective analysis medically refractory epilepsy patients (2016-2019). Patients with medically refractory epilepsy were selected based upon our noninvasive protocol (clinical semiology, interictal scalp electroencephalography (EEG), long-term video EEG monitoring data, and magnetic resonance injury [MRI]). The follow-up was noted from the last out-patient visit record or throu gh telephonic conversation (International League Against Epilepsy score). Results  Of 23 cases of TLE ( n = 7, mesial temporal sclerosis; n = 16 temporal lobe like cavernomas, tumors, or arterio-venous malformations). Single photon emission computed tomography/positron emission tomography (SPECT/PET) was performed in five cases (three cases of ictal/interictal SPECT and two cases of PET scan) where there was discordance between EEG/clinical and MRI. The median follow-up was of 19 months with 18 cases being seizure free. Five cases were fully off the antiepileptic drug (AEDs) while in 15 cases, the AEDs dosages or the number were reduced. Average number of AEDs reduced from 2.9 in preoperative period to 1.2 postoperatively. Two cases had quadrantanopia and one case of cerebrospinal fluid leak. Conclusion  A multidisciplinary and holistic approach is required for best patient care. The results of our initial surgical experience are encouraging. PMID: 33531782 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.