Anterior temporal lobectomy is effective surgery for certain types of seizures in patients with temporal lobe epilepsy, according to a study conducted by researchers at Emory University. The study is published in the December 26 issue of the journal, Neurology. "While temporal lobe epilepsy (TLE) is the single most common type of epilepsy, only about half of patients fully control their seizures with medications," said Thomas R. Henry, M.D., principal investigator, director of the Emory Epilepsy Center and associate professor of neurology at the Emory University School of Medicine. "In patients with epilepsy, a network of brain cells, which is distributed over widespread brain systems, must participate in starting and stopping seizures. Our study finds that in patients with TLE, the network of brain cells that generate complex partial seizures, or psychomotor seizures, are at least partly separate from the networks that produce generalized tonic-clonic seizures, commonly known as grand mal seizures. We found that temporal lobectomy is highly effective in stopping complex partial seizures among patients who have seizures that cannot be controlled by medication, but is clearly less effective in stopping generalized tonic-clonic seizures in the same patients."
Dr. Henry and his team of investigators studied 60 patients who had temporal lobectomies performed at the University of Michigan between March 1991 and March 1994 and who had seizure records available for at least two years prior to surgery and two years after surgery. They discovered that the total number of seizures (both complex partial and grand mal seizures) experienced by these patients after surgery was significantly lower than the total number they experienced before surgery, although the fraction of grand mal seizures was significantly higher post-operatively.
"Most patients experienced no seizures at all after surgery," Dr. Henry noted. "However, those who did were more likely to experience grand mal seizures."
It's common in complex partial seizures for patients to lose consciousness for less than a minute, but typically do not fall or have jerking of the entire body. During a grand mal seizure, the patient usually falls and is unconscious. The entire body becomes tense and jerks uncontrollably. Breathing may stop briefly. The person usually has no memory of the event upon regaining consciousness, and may have headaches or feel a need to sleep. "This study provides a lot of information about epilepsy surgery that hadn't been discovered in the past," Dr. Henry said.
Dr. Henry conducted his research with Ivo Drury, MBBCh and Lori Schuh, M.D., both from the department of neurology at Henry Ford Hospital in Detroit, and Donald Ross, M.D., from the section of neurosurgery at the University of Michigan.
The Emory Epilepsy Center was established in 1994 and is a comprehensive effort among Emory neurologists, neurosurgeons, neuropsychologists, radiologists, researchers and nurses to offer adults and children with epilepsy access to the most advanced diagnostic, medication and surgical options.
Materials provided by Emory University Health Sciences Center. Note: Content may be edited for style and length.
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