EFFECTIVENESS OF TEMPORAL LOBECTOMY MEASURED BY YEARLY FOLLOW-UP AND MULTIVARIATE-ANALYSIS

Yearly follow-up data and multivariate analysis explored the effective ness of temporal lobectomy for complex partial (CPS) and generalized m otor seizures in 125 patients for 3 follow-up intervals: second year, last year, and average for all years. Eighty-four to eighty-eight perc ent of the 45 patients with only CPS were seizure-free (SF) at follow- up. Among 80 patients with both seizure types preoperatively, 75-84% h ad no CPS and 68-73% had no generalized motor seizures in the outcome intervals. Eighty-two percent of SF patients at 1 year remained so at 5 years, whereas 40% with rare seizures at 1 year were SF at 5 years. Forty-four percent of those with <90% improvement at 1 year became SF at 3 years and maintained that at 5 years, whereas only 9% of <90% imp rovement patients at 2 years became SF at 5 years. Only 6% of SF patie nts at 1 year had <90% improvement at 5 years. Multivariate analysis d isclosed the following factors auguring favorable outcomes: febrile co nvulsions as etiology, lack of nonfebrile generalized motor seizures, highly lateralized EEG spikes, lack of extratemporal spikes, younger a ge at surgery, and no seizures within 1 week of operation.