Evaluación anatomofuncional de sistemas sensoriales en pacientes con epilepsia del lóbulo temporal mesial sometidos a tratamiento quirúrgico

Introduction: The present investigation studies, for the first time in our country, the consequences on the sensory auditory and visual systems after surgery for drug resistant temporal lobe epileptic patients. Objectives: The aim of the study was to evaluate the anatomic and functional changes after electrocorticography-guided anterior-temporal lobectomy. Methods: A sample of 28 patients that underwent surgery for drug resistant temporal lobe epilepsy was studied. The surgery was performed at the International Center for Neurological Restoration (CIREN) between years 2002-2012. Results: Functional alterations in the visual and auditory systems were detected even before surgery. After surgery further auditory alterations were detected by auditory evoked potentials, likely as an indirect, long-term consequence of the resection of specific structures like the amygdala and the medial temporal pole. On the visual system, the resection of the epileptogenic zone provoked visual deficits, evidenced by visual perimetry combined with quadrant-restricted visual evoked potentials. The visual defects are in good correspondence with the amount of resected tissue. Lesions within the visual pathway were confirmed by optic radiation tractography and connectivity studies. Conclusions: indirect and long term functional changes of the auditory pathway were described, while direct lesions of the visual pathway were confirmed with objective methods of exploration, according to the surgical resection magnitude.