Surgical outcomes in patients with drug-resistant bilateral temporal lobe epilepsy confirmed via magnetic resonance imaging

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Abstract

Introduction. In patients with drug-resistant temporal lobe epilepsy (TLE), surgical treatment is aimed to resect an epileptogenic zone (EZ) followed by seizure control. Despite complicated EZ location, surgical resection should be considered as a treatment of choice in bilateral TLE.

Objective: to evaluate surgical outcomes and factors contributing to outcomes in patients with drug-resistant bilateral TLE confirmed via magnetic resonance imaging.

Materials and methods. The study included patients with unilateral (n = 50) and bilateral (n = 50) temporal lobe involvement. The results of surgical treatment were evaluated according to the classification of J. Engel (1993).

Results. Favorable outcomes of surgical treatment (Engel I and Engel II) in the group with unilateral temporal lobe involvement were found in 98% of patients after 12 months, in 88% after 24 months, and in 100% after 48 and 60 months after surgery. In the group with bilateral temporal lobe involvement outcomes of surgical treatment were favorable in 41% of patients after 12 months, in 50% after 24 months, in 39% after 48 months, and in 50% of patients after 60 months post-surgery.

Conclusion. Early onset, burdened perinatal history, and MRI-confirmed left temporal lobe involvement contribute to the poor outcome (Engel III and Engel IV) in the bilateral TLE group. Engel I outcomes were more common in the patients with unilateral TLE while Engel II–IV outcomes were more common in the patients with bilateral TLE.

About the authors

Vladimir V. Krylov

Pirogov Russian National Research Medical University; N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: navruzov357@yandex.ru
ORCID iD: 0000-0001-5256-0905

D. Sci. (Med.), Professor, RAS Full Member, Head, Department of fundamental neurosurgery, Faculty of Additional Professional Education, main researcher, Department of neurosurgery

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4; Moscow

Anna B. Gekht

Pirogov Russian National Research Medical University; Z.P. Solovyov Scientific and Practical Psychoneurological Center

Email: navruzov357@yandex.ru
ORCID iD: 0000-0002-1170-6127

D. Sci. (Med.), Professor, Director, Professor, Department of neurology and neurosurgery

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4; Moscow

Anna V. Lebedeva

Pirogov Russian National Research Medical University; Z.P. Solovyov Scientific and Practical Psychoneurological Center

Email: navruzov357@yandex.ru
ORCID iD: 0000-0001-8712-4775

D. Sci. (Med.), Head, Department for the study of paroxysmal states and dyssomnia in borderline mental disorders

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4; Moscow

Flora K. Rider

Z.P. Solovyov Scientific and Practical Psychoneurological Center

Email: navruzov357@yandex.ru
ORCID iD: 0000-0003-1180-0700

Cand. Sci. (Med.), leading researcher, Department of epidemiology, prevention and help organization in borderline mental disorders

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Igor S. Trifonov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: navruzov357@yandex.ru
ORCID iD: 0000-0002-6911-0975

Cand. Sci. (Med.), Associate Professor, Department of neurosurgery and neuroresuscitation

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Igor L. Kaimovsky

Z.P. Solovyov Scientific and Practical Psychoneurological Center; City Clinical Hospital named after V.M. Buyanov

Email: navruzov357@yandex.ru
ORCID iD: 0000-0001-7371-7182

Cand. Sci. (Med.), leading researcher, Department for the study of paroxysmal states and dyssomnia in borderline mental disorders, Head, Regional department of paroxysmal disorders

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4; Moscow

Mikhail V. Sinkin

N.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: navruzov357@yandex.ru
ORCID iD: 0000-0001-5026-0060

Cand. Sci. (Med.), Head, Laboratory of invasive neural interfaces, «Techobiomed» Research Institute, senior researcher, Emergency neurosurgery department

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4; Moscow

Olga O. Kordonskaya

Federal Center for Brain and Neurotechnologies

Email: navruzov357@yandex.ru
ORCID iD: 0000-0003-0432-2915

Cand. Sci. (Med.), neurosurgeon

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Alexander A. Yakovlev

Z.P. Solovyov Scientific and Practical Psychoneurological Center

Email: navruzov357@yandex.ru
ORCID iD: 0000-0003-2546-5130

D. Sci. (Biol.), leading researcher, Department for the study of paroxysmal states and dyssomnia in borderline mental disorders

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Ilya G. Komoltsev

Z.P. Solovyov Scientific and Practical Psychoneurological Center

Email: navruzov357@yandex.ru
ORCID iD: 0000-0002-4918-6411

researcher, Department for the Study of paroxysmal states and dyssomnia in borderline mental disorders

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Akhmed I. Magomedsultanov

Moscow Multidisciplinary Clinical Center "Kommunarka"

Email: navruzov357@yandex.ru

neurosurgeon, Clinical Centre of Orofacial Surgery and Dentistry

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

Rashid A. Navruzov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: navruzov357@yandex.ru
ORCID iD: 0000-0002-4823-6042

neurosurgeon, Moscow Multidisciplinary Clinical Center "Kommunarka"

Russian Federation, 111398, Moscow, Kuskovskaya str, 1a, build. 4

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Supplementary files

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2. Fig. 1. Surgical outcomes 12 months post operation.

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3. Fig. 2. Surgical outcomes 24 months post operation.

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4. Fig. 3. Surgical outcomes 48 months post operation.

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5. Fig. 4. Surgical outcomes 60 months post operation.

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Copyright (c) 2022 Krylov V.V., Gekht A.B., Lebedeva A.V., Rider F.K., Trifonov I.S., Kaimovsky I.L., Sinkin M.V., Kordonskaya O.O., Yakovlev A.A., Komoltsev I.G., Magomedsultanov A.I., Navruzov R.A.

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