OUTCOME AFTER TEMPORAL LOBECTOMY IN BILATERAL TEMPORAL-LOBE EPILEPSY

We determined how noninvasive presurgical data relate to prognosis aft er temporal lobectomy in patients with independent bilateral temporal lobe (IBTL) complex partial seizures on the intracranial electroenceph alogram (EEG). Between 1986 and 1994, 28 patients had IBTL seizures on intracranial EEG. Fifteen of these 28 patients underwent temporal lob ectomy and 13 were not offered surgery. Of the 15 patients who had sur gery, 10 patients became seizure-free. Magnetic resonance imaging (MRI ) and the Wada test were the only variables associated with a seizure- free outcome. Seven of 10 seizure-free patients had a lateralized Wada result or the presence of unilateral hippocampal sclerosis, whereas n one of the patients with persistent seizures had either of these findi ngs. Variables not found to be predictive of a seizure-free outcome in cluded location of scalp interictal spikes, degree of seizure-onset la terality, presence of early epilepsy risk factor, duration of epilepsy , and full-scale intelligence quotient. We conclude that MRI and the W ada test provide information of prognostic value in patients with bila teral temporal seizures independent of intracranial EEG data.