2025 American Academy of Neurology Abstract Website

Jimena Gonzalez Salido¹, Luis Marin-Castañeda², Jimena Colado¹, Irving Fuentes¹, Fernando Vasquez Lopez¹, Betsy Vazquez¹, Mijail A. Rivas-Cruz¹, Eithel A. Valenzuela-Mendívil¹, Salvador Martínez-Medina³, Paulina de Angoitia-Flores⁵, Alfonso Arellano-Reynoso⁴, Mario A. Sebastián-Díaz⁶, Iris E. Martínez-Juárez¹
¹Epilepsy Clinic, Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery “Manuel Velasco Suarez” (NINNMVS) & Faculty of Medicine, UNAM, Mexico City and Clinical Epileptology Fellowship NINNMVS/UNAM, ²Department of Neurophysiology, ³Neurology Residency, ⁴Functional Neurosurgery Department, National Institute of Neurology and Neurosurgery. Mexico City, Mexico., ⁵Faculty of Medicine, Panamerican University, ⁶Nephrology Department, , South Central High Specialty Hospital PEMEX, Mexico City, Mexico.

Objective:

Compare postoperative outcomes in terms of five-year seizure freedom in patients with temporal lobe epilepsy (TLE) who underwent epilepsy surgery.

Background:

TLE is the most common form of focal epilepsy and a frequent cause of drug-resistant epilepsy (DRE), making temporal lobectomy (TL) an effective therapeutic option.

Design/Methods:

Observational, descriptive, and cross-sectional study in patients with TLE treated at the Epilepsy Clinic at a Neurological Hospital in Mexico. SPSS® 29 was used for the analysis. Quantitative variables were expressed as mean and standard deviation and analyzed using the Student's t-test or a non-parametric equivalent. Qualitative variables were expressed as frequencies and percentages and analyzed using Pearson's Chi-square or Fisher's exact tests.

Results:

A total of 89 patients were included, 53 (59.6%) were female and had a mean age of 36.13 years (IQR: 28, 42). Anterior temporal lobectomy (ATL) was performed in 64 (71.91%) patients, amygdalohippocampectomy in 15 (16.9%) patients, parahippocampectomy in 5 (5.6%) patients, and lesionectomy in 5 (5.6%) patients. Mean number of preoperative seizures was 11.0 ± 10.02 (1-60), and postoperative seizures were 1.2 ± 2.97 ( 0-19), with significant differences between them (p>0.001). There was a significant reduction (p>0.001) in the number of antiseizure medications (ASM). Regarding seizure freedom, 59 (66.29%) patients were in Engel class I during the first and second years, 60 (67.4%) in the third year, and 58 (65.1%) in the fourth and fifth years. Considering the type of surgery and seizure freedom, it was found that during the 1-3 year follow-up period, there was no significant difference (p=0.06), but in the 4th and 5th years, patients who underwent amygdalohippocampectomy and ATL had a lower recurrence of seizures (p=0.041).

Conclusions:

Surgical resection in patients with TLE was associated with greater seizure freedom that did not vary over time. ATL had a lower risk of seizure recurrence over the five-year follow-up period.