Objective:

To evaluate postoperative seizure outcomes, seizure freedom, and clinical factors in patients with TLE undergoing surgical resection, over a ten-year follow-up period.

Background:

Temporal lobe epilepsy (TLE) is the most frequent form of focal epilepsy and a major cause of drug-resistant epilepsy (DRE). Temporal lobectomy (TL) is an established therapeutic option for selected patients who fail pharmacological treatment.

Design/Methods:

We conducted a descriptive, cross-sectional study of patients with TLE treated at the National Institute of Neurology and Neurosurgery. Descriptive and univariate analyses were performed using SPSS® 29. Quantitative variables were analyzed with Student’s t-test or Mann–Whitney U test, and qualitative variables with Pearson’s Chi-square or Fisher’s exact test.

Results:

A total of 146 patients were included (52.7% female, mean age 52.0 years). The mean number of seizures significantly decreased from 14.36 ± 9.93 preoperatively to 2.08 ± 0.84 postoperatively (p < 0.001). Anterior temporal lobectomy was performed in 71.9%, amygdalohippocampectomy in 16.9%, parahippocampectomy in 5.6%, and lesionectomy in 5.6%. A significant reduction in antiseizure medications was observed after surgery (p < 0.001).

Seizure freedom (Engel Class I) was achieved in 66.3% at years 1–2, 67.4% at year 3, 65.1% at years 4–5, and increased to 80.2% at year 10 (p < 0.001). The association between seizure freedom and MRI lesion was not significant (p = 0.087). Amygdalohippocampectomy and temporal lobectomy were associated with lower seizure recurrence from years 4–10 (p = 0.041).

Conclusions:

Temporal lobe surgery provides sustained seizure freedom and significantly reduced use of ASM  over ten years of follow-up, supporting its long-term efficacy in patients with drug-resistant TLE. Complete resection of the temporal lobe and amygdala also rendered better seizure control. In this study MRI findings did not significantly affect seizure outcome.