A COMPARATIVE-STUDY OF LESIONECTOMY VERSUS CORTICECTOMY IN PATIENTS WITH TEMPORAL-LOBE LESIONAL EPILEPSY

We performed a retrospective study comparing surgical outcome of anter ior temporal lobectomy (n = 20) and stereotactic lesionectomy (n = 14) in 34 consecutive patients with intractable partial epilepsy evaluate d at this institution between lune 1986 and Tune 1992. All patients ha d medically refractory partial seizures and a neuroimaging-identified temporal lobe foreign-tissue lesion. Patients underwent a pre- and pos toperative comprehensive evaluation. In all patients, postoperative ne uroimaging studies indicated complete lesion resection. Seventy-one pe rcent of lesionectomy patients and 90% of lobectomy patients, respecti vely, experienced a worthwhile reduction in seizure tendency. Forty-th ree percent of lesionectomy patients and 85% of lobectomy patients, re spectively, were seizure-free postoperatively. Mean duration of follow -up was 51 months (range, 21-83 months). Morbidity occurred in three p atients who underwent corticectomy: complete homonymous hemianopsia (1 ) and dysphasia (2). No significant morbidity was associated with lesi onectomy. Results of this study have altered the surgical strategy at this institution for patients with temporal lobe lesional epilepsy and have proved useful in counseling patients regarding neurologic outcom e.