Evaluación clínica pre y posquirúrgica de pacientes con epilepsia refractaria del lóbulo temporal. Estudio preliminar

Epilepsy affects 1-2% of population and 20% of patients are cronic medically untreatable. 5-10% are candidates to epilepsy surgery with favorable results in life quality and reduction of crisis. Epilepsy Surgery Project started at CIREN in phase I with temporal lobe epilepsy. Objective: To implement the management of patient during presurgical evaluation and to standardize the clinical attention after surgical treatment with outcome. Material and Method: It is a prospective and monocenter clinical study. We evaluated patients with refractory epilepsy in a clinic during presurgical evaluation. Necessary investigations were performed in order to specify the refractory aetiology. The patients were admitted at Telemetry Unit for video EEG search. Our staff decided the surgical criterion. Adjusted temporal lobectomy and transsurgical electrocorticographic were performed. Patients had periodic postsurgical evaluation. Results: 15 patients were operated. The majority are between 20-49 years. There wasn’t any difference related to sex. Fever convulsion was the most important antecedent. Many patients with 10 years or more were found. The majority had complex partial crisis with generalization. Complications and anatomopathology are described. Postsurgical evolution showed 73% of patient’s crisis free. Conclusions: Temporal lobectomy is a technique that reduces crisis frequency in refractory epilepsy.