Surgery for temporal lobe epilepsy in Semarang,Indonesia: The first 56 patients with follow up longer than 12 months

Abstract

Until October 2005, surgery were performed for 76 intractable temporal lobe epilepsy patients. Among them, 56 patients had follow-up of 12-76 months. The patients consisted of 35 males and 21 females,age between 3-38 year-old. Magnetic Resonance Imaging diagnoses were hippocampal sclerosis in 50 patients, temporal lobe tumor in 3 patients, hemispheric hemiatrophy, calcified hippocampal lesion and normal imaging one patient each. Intracranial subdural grid EEG was performed in the patient with normal imaging. Psychological evaluation was performed in all patients, while Wada test was performed on patients with left-sided lesion. All patients underwent anterior temporal lobectomy. Seizure free (Engel’s I) was seen on 46 patients (82%). Six patients (11%) had less than 2 seizures per year (Engel’s II). Seizure decreased by more than 75% (Engel’s III) in 4 patients (7%). There was a trend with increased number of patients with Engel’s II and III with longer duration of seizures. Complications were extradural empyema in 5 patients (9%), depression in 2 patients (4%), transient hemiparesis in one patient (2%). Thirty-one patients were able to withdraw the antiepileptic drugs. In conclusion, epilepsy surgery can achieve good results in developing countries.