Background: The most common cause of drug resistant epilepsy is the temporal lobe seizures especially that caused by medial temporal lobe epileptogenic lesions.
OBJECTIVE: To assess the clinical outcome of medial temporal lobe lesionectomy (without amygdalo-hippocampectomy) in control of seizures in a group of drug resistant epileptic patients.
Material and methods: This study was conducted on 12 patients (8 males) presented to al-azhar university hospitals between October, 2018 and December, 2020 with drug resistant -temporal lobe- epilepsy due to medial temporal lobe lesions of different pathological natures not affecting the hippocampus, the lesions were surgically excised and had been followed up in out-patient clinic.
Results: This study revealed that all patients presented with drug resistant epilepsy with medial temporal lobe lesions, underwent surgical excision of the lesions without amygdalo-hippocampectomy and followed up for at least 10 months w. The post-operative outcome of epilepsy was evaluated by Engel classification system with all patients becoming grade I (6 patients 50% already stopped anti-epileptics –AEDs- , while the remaining 50 % of patients is still on AEDs but with significant reduction of doses and number of AEDs). No memory affection or complications of significant long term sequel were observed.
Conclusions: medial temporal lobe lesionectomy without amygdalo-hippocampectomy carries significant clinical improvement of seizures in drug resistant epilepsy caused by medial temporal lobe lesions.