TREATMENT OF TEMPORAL-LOBE EPILEPSY

Initial management of patients with temporal lobe epilepsy is with ant iepileptic drugs, but these control seizures in only half the patients . Patients refractory to drugs should be evaluated for resective surge ry. That evaluation requires identification of a focus of onset of sei zures, as well as establishing that the focus is in an area of the bra in that can be removed with a low risk of new neurologic deficits. Tec hniques used in that evaluation, including electroencephalography, ima ging, recording from intracranial electrodes, use of the intracarotid amobarbitol perfusion test, and the role of specialized studies such a s positron emission tomography, are reviewed, along with the correlati on of the findings on that evaluation to the control of seizures after surgery. The different surgical techniques for temporal lobe resectio ns are also reviewed, along with the risks of surgery, particularly to recent memory, and the changes in quality of life following surgery.